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ROBOTIC VERSUS LAPAROSCOPIC ILEAL-CECAL RESECTION FOR CROHN'S DISEASE: A META-ANALYSIS
federica galiandro
*, gianmarco panzera, franco sacchetti, angelo eugenio potenza, dario pastena, paola caprino, domenico balzano, carmen nesci, luigi sofo
medical and surgical sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy
IntroductionCrohn's disease (CD) may require surgical intervention, often in the form of ileocecal resection (ICR). Minimally invasive approaches, including laparoscopic and robotic surgery, have become increasingly common for ICR. However, the debate over the optimal surgical approach for CD persists. This meta-analysis compares the outcomes of robotic and laparoscopic ICR in patients with CD.
MethodsWe conducted a comprehensive search in electronic databases (PubMed, Scopus, Embase, Cochrane Library) for studies comparing robotic and laparoscopic ICR for CD. Observational studies (both retrospective and prospective) were included. Data were extracted on operative time, length of hospital stay, major complication rates, readmission rates, and time to return of bowel function. Meta-analyses were performed using RevMan 5 software.
ResultsTwo studies (one retrospective and one prospective) met the inclusion criteria, with a total of 286 patients. Laparoscopic ICR was associated with a significantly shorter operative time compared to robotic ICR (mean difference [MD], 84.13 minutes; 95% confidence interval [CI], 57.39 to 110.88 minutes; P < 0.00001). No significant difference was observed in the length of hospital stay (standardized mean difference [SMD], -0.19 days; 95% CI, -0.66 to 0.28 days; P = 0.43) or in major complication rates (MD, -7.54; 95% CI, -21.22 to 6.13; P = 0.28) between the two approaches. Robotic ICR was associated with a shorter time to return of bowel function compared to laparoscopic ICR (MD, -0.65 days; 95% CI, -1.03 to -0.27 days; P = 0.0008).
ConclusionsRobotic ICR is associated with a longer operative time and a faster return of bowel function compared to laparoscopic ICR in patients with CD. However, no significant differences were observed in hospital stay duration or major complication rates between the two approaches. Further studies with larger sample sizes are needed to confirm these results and identify the most appropriate surgical approach for individual patients.
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