Robotic colon surgery in obese patients: a systematic review and meta-analysis

Wang, J; Johnson, NW; Casey, L; Carne, PWG; Bell, S; Chin, M; Simpson, P; Kong, JC

Author(s): Wang, J; Johnson, NW; Casey, L; Carne, PWG; Bell, S; Chin, M; Simpson, P; Kong, JC;
Details: Publication Year 2023-01,Volume 93,Issue #1-2,Page 35-41
Journal Title: ANZ Journal of Surgery
Publication Type: Review
Abstract: BACKGROUND: Colon cancer resection can be technically difficult in the obese (OB) population. Robotic surgery is a promising technique but its benefits remain uncertain in OB patients. The aim of this study is to compare OB versus non-obese (NOB) patients undergoing robotic colon surgery, as well as OB patients undergoing robotic versus open or laparoscopic colonic surgery. METHODS: A systematic review and meta-analysis was performed. Primary outcome measures included length of stay (LOS), surgical site infection (SSI) rate, complications, anastomotic leak and oncological outcomes. RESULTS: A total of eight studies were included, with five comparing OB and NOB patients undergoing robotic colon surgery included in meta-analysis. A total of 263 OB patients and 400 NOB patients formed the sample for meta-analysis. There was no significant difference between the two groups in operative time, conversion to open, LOS, lymph node yield, anastomotic leak and postoperative ileus. There was a trend towards a significant increase in overall complications and SSI in the OB group (32.3% OB versus 26.8% NOB for complications, 14.2% OB versus 9.9% NOB for SSI). The three included studies comparing surgical techniques were too heterogeneous to undergo meta-analysis. CONCLUSION: Robotic colon surgery is safe in obese patients, but high-quality prospective evidence is lacking. Future studies should report on oncological safety and the cost-effectiveness of adopting the robotic technique in these challenging patients.
Publisher: Wiley
Keywords: Humans; *Robotic Surgical Procedures/adverse effects; Anastomotic Leak/epidemiology; Prospective Studies; *Robotics; Colon; Obesity/complications; *Laparoscopy/adverse effects/methods; Surgical Wound Infection/complications; Length of Stay; Postoperative Complications/epidemiology/etiology; Treatment Outcome; colorectal; laparoscopic; obesity; robotic surgical procedures
Department(s): Surgical Oncology
PubMed ID: 35502636
Publisher's Version: https://doi.org/10.1111/ans.17749
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-06-15 07:24:53

Last Modified: 2023-06-15 07:25:48