SP6.07 Outcomes of Laparoscopic Vs Modern Robot Assisted Surgery for Rectal Cancer in Adults – A Systematic Review

Relevance and aims Rectal cancer is one of the world’s most common malignancies, with 700,000 new diagnoses per year globally. Robotic assisted surgery (RAS) is increasingly common in the UK and has several technical advantages. While there have been many previous studies comparing laparoscopy to RAS, few reviews have focussed on recent practice within the last 5 years. As experience amongst surgeons performing RAS increases it is unclear if outcomes are changing. Methods A systematic review of the literature within the last 5 years was conducted using the databases PubMed (including Medline and the Cochrane library) and Scopus, to compare 8 different outcomes: intraoperative blood loss, number of harvested lymph nodes, operative time, conversion to open surgery, duration of hospital stay, urinary retention, anastomotic leak, and survival. Results 24 studies were included, consisting of 7899 total patients. The RAS group had statistically significant lower postoperative days in hospital and lower conversion rates to open surgery, albeit with significantly higher operating time. There was no conclusive significant difference between the groups for the other outcomes. Conclusions RAS is useful for low rectal cancer and the less accessible pelvis; it may also have a greater ability to preserve pelvic nerves and their function. The shorter hospital stay may have a health economic benefit but must be weighed against longer operating time and associated theatre costs. Future research should focus on comparisons between experienced laparoscopic surgeons and experienced robotic surgeons to best compare outcomes.