Robotic-Assisted Surgery for Rectal Cancer: An Expedited Summary of the Clinical Evidence.

BACKGROUND: Rectal cancer is a disease in which cancer cells form in the rectum, which has the primary function of temporarily storing feces, controlling defecation, and maintaining continence. Surgery is the most common treatment for rectal cancer; surgical approaches include open, laparoscopic, and robotic assisted. We conducted an expedited summary of the clinical evidence for robotic-assisted surgery for rectal cancer, which included an evaluation of effectiveness and safety.

METHODS: We performed a systematic literature search of the clinical evidence to retrieve systematic reviews and randomized controlled trials (RCTs). We assessed the risk of bias in the included systematic reviews using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews, version 2), and we assessed the risk of bias in the included RCT using the Cochrane Risk-of-Bias Tool for Randomized Trials, version 1. We reported the quality of the body of evidence as evaluated in the included systematic reviews according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group criteria if it was evaluated.

RESULTS: We included 14 studies in the clinical evidence review (12 systematic reviews and 1 RCT on robotic-assisted vs. laparoscopic rectal cancer surgery and 1 systematic review on robotic-assisted vs. open rectal cancer surgery). Compared with laparoscopic rectal cancer surgery, robotic-assisted rectal cancer surgery may result in similar overall survival; similar rates of conversion, blood transfusion, and readmission,· reduced blood loss; shorter length of stay; and improved quality of life. Compared with open rectal cancer surgery, robotic-assisted rectal cancer surgery may result in similar overall survival, reduced blood loss, and shorter length of stay.

CONCLUSIONS: Robotic-assisted rectal cancer surgery may result in similar or improved clinical outcomes compared with laparoscopic and open rectal cancer surgery.