Robotic versus laparoscopic surgery for rectal cancer in male urogenital function preservation, a meta-analysis

BACKGROUND: Urogenital dysfunction after rectal cancer surgery can largely affect patients’ postoperative quality of life. Whether robotic surgery can be a better option when comparing with laparoscopic surgery is still not well-known. METHODS: Comprehensive search in PubMed, Embase, Cochrane Library, and Clinical Trials was conducted to identify relevant studies in March 2018. Studies comparing robotic surgery with laparoscopic surgery were included. Measurement of urogenital function was through the International Prostate Symptom Score and International Index of Erectile Function. RESULTS: Six studies with 386 patients in robotic group and 421 patients in laparoscopic group were finally included. Pooled analysis indicated that bladder function was better at 12 months in the robotic group after the procedures (mean difference, − 0.30, 95% CI, − 0.52 to − 0.08). No significant difference was found at 3 and 6 months postoperatively (mean difference, − 0.37, 95% CI, − 1.48 to 0.73; mean difference, − 1.21, 95% CI, − 2.69 to 0.28). Sexual function was better at 3 months in the robotic group after surgery (mean difference, − 3.28, 95% CI, − 6.08 to − 0.49) and not significantly different at 6 and 12 months. (mean difference, 3.78, 95% CI, − 7.37 to 14.93; mean difference, − 2.82, 95% CI, − 8.43 to 2.80). CONCLUSION: Robotic surgery may offer faster recovery in urogenital function compared to laparoscopic surgery for rectal cancer.