In this study, we compared short-term efficacy, safety and feasibility between laparoscopic left hemicolectomy and robotic-assisted left colectomy using Meta-analysis.

We conducted a systemic literature review on laparoscopic versus robotic-assisted left hemicolectomy by searching the Pubmed, Embase, Web of Science, Wanfang, Weipu, CBM, CNKI and other databases, dated from the establishment of the database to August 2019. The quality of the literature was evaluated by NOS score, and statistical analysis was performed using ReviewManager 5.3 software.

A total of 12 articles were included in this study with a total of 4 633 patients. There were 2 409 patients in the laparoscopic group and 2 224 patients in the robotic-assisted group. The Meta-analysis showed that compare to the robotic-assisted group, the laparoscopic group had higher amount of blood loss (MD=11.07, 95%CI=3.65~18.5; P=0.003<0.05), higher rate of conversion to open (OR=1.74, 95%CI=1.40~2.16; P<0.001), more postoperative complications (OR=1.30, 95%CI=1.00~1.69; P=0.05), and longer hospital stay (MD=0.74, 95%CI=0.19~1.30; P=0.008<0.05). However, the laparoscopic procedures had significant advantages with shorter operation time (MD=-55.06, 95%CI=-69.84~-40.28; P<0.001), and lower costs (MD=-2 435.43, 95%CI=-3 575.16~-1 295.70; P<0.001). There was no statistically significant difference in the others between the two groups. The comparison of each subgroup was consistent with that of the whole group.

Robotic-assisted left hemicolectomy was favorable regarding both short-term efficacy and safety, but because of the steep learning curve of this technique and the high costs of the procedures, whether this procedure can completely replace laparoscopic surgery remains unclear due to the relative novelty of these surgical approaches.