Meta-Analysis of Transanal vs. Robotic Total Mesorectal Excision for Rectal Cancer

Hiroshi Ohtani1*, Shinya Nomura1, Yoshihito Yamakoshi1, Mizuki Nagamori1, Hiroji Nakagawa1, Yoshioki Ohno1, Yoshiteru Ohno2, Kiyoshi Maeda3, Hisashi Nagahara3, Masatsune Shibutani3, Tatsunari Fukuoka3, Yasuhito Iseki3, Kosei Hirakawa3, and Masaichi Ohira3

1Department of Surgery, Ohno Memorial Hospital, Osaka, Japan 2Department of Internal Medicine, Ohno Memorial Hospital, Osaka, Japan
3Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan

^*Correspondance to: Hiroshi Ohtani 

 PDF  Full Text DOI: 10.25107/2474-1647.2803

Abstract

Background/Aim: A meta-analysis was conducted to evaluate and compare the short- and longterm outcomes of transanal total mesorectal excision and robot-assisted total mesorectal excision for rectal cancer. Methods: We searched MEDLINE et al. for relevant papers published between 2010 and February 2020 by using specific search terms. For the short-term analysis, we collected data on the perioperative period, clinical course, postoperative complications, and pathological findings. For the long-term analysis, the rates of overall, distant, and local recurrence were examined. Results: We identified 5 papers reporting results that compared transanal total mesorectal excision for rectal cancer with robot-assisted total mesorectal excision. Our meta-analysis included 863 patients with rectal cancer; 348 had undergone transanal total mesorectal excision, and 515 had undergone robot-assisted total mesorectal excision. No significant difference was found in the operative time, conversion rate to laparotomy, and circumferential resection margin between the two groups. The rates of overall recurrence, distant recurrence, and local recurrence were not significantly different. Transanal total mesorectal excision results in almost similar outcomes in the short-term and in the long-term, compared to robot-assisted total mesorectal excision. Conclusion: Transanal total mesorectal excision and robot-assisted total mesorectal excision may be as incomparable as each other as surgical procedures for rectal cancer.

Keywords

Rectal Cancer; Robot-assisted Total Mesorectal Excision; Transanal Total Mesorectal Excision; Meta-analysis

Cite the article

Ohtani H, Nomura S, Yamakoshi Y, Nakagawa H, Ohno Y, Maeda K, et al. Meta-Analysis of Transanal vs. Robotic Total Mesorectal Excision for Rectal Cancer. Clin Surg. 2020; 5: 2803..