Robot-assisted versus conventional laparoscopic operation in anus-preserving rectal cancer: a meta-analysis

Figures & data

Figure 1 Flow diagram of study selection for meta-analysis.

Table 1 Characteristics of patients in studies included in the meta-analysis

Study	Country	Robotic and laparoscopic mean BMI	Sex (M:F)	Tumor location from anal verge (n)			Previous surgery (%)	Pre-op CRT (%)	Ileostomy (%)	Leak rate (%)
				Upper	Middle	Lower
Erguner et al^Citation14	Turkey	R-LAR: 28.3	14:13	8	16	3	–	4 (14.81)	–	–
		L-LAR: 26.8	20:17	20	13	4	–	8 (21.62)	–	3
Baek et al^Citation15	South Korea	R-LAR: 23.4	31:16	–	–	–	–	–	–	4 (8.5)
		L-LAR: 23.4	28:9	–	–	–	–	–	–	3 (8.1)
D’Annibale et al^Citation16	Italy	–	30:20	8	9	33	–	34	–	5 (10)
		–	30:20	21	12	17	–	28	–	7 (14)
Baik et al^Citation17	South Korea	R-LAR: 23.4	37:19	–	–	–	1 (1.8)	5 (8.9)	–	1
		L-LAR: 23.2	34:23	–	–	–	5 (8.8)	7 (12.3)	–	4
Park et al^Citation18	South Korea	R-LAR: 23.1	86:47	40	60	33	10 (7.5)	15 (11.3)	29 (21.8)	6
		L-LAR: 22.9	60:24	31	37	16	11 (13.1)	10 (11.9)	20 (23.8)	3
Pigazzi et al^Citation19	US	R-TME: 31.0	2:4	–	–	–	2	2	–	–
		L-TME: 27.0	4:2	–	–	–	3	2	–	–
Park et al^Citation20	South Korea	R-ISR: 23.9	28:12	–	–	–	4 (10.0)	32 (80.0)	14 (35.0)	3
		L-ISR: 24.3	25:15	–	–	–	8 (20.0)	20 (50.0)	6 (14.3)	2
Kim and Kang^Citation21	South Korea	R-TME: 23.6	70:30	19	49	32	7	14 (14.0)	30 (30.0)	8 (8.2)
		L-TME: 23.5	57:43	17	64	19	10	7 (7.0)	27 (27.0)	11 (11.1)
Serin et al^Citation22	Turkey	R-TME: 24.7	14:0	–	–	–	–	14	–	1
		L-TME: 26.0	65:0	–	–	–	–	65	–	6

Abbreviations: BMI, body mass index; CRT, chemoradiation therapy; LAR, low anterior resection; TME, total mesorectal excision; ISR, intersphincteric resection.

Table 2 Characteristics of the nine selected studies included in the meta-analysis

Study	Year	Country	Study size (n)			TME	Objective	Randomized	Follow-up	Intervention
			Total	R-LAR	L-LAR
Baik et al^Citation17	2009	South Korea	113	56	57	Yes	Yes	No	Yes	No
Baek et al^Citation15	2013	South Korea	84	47	37	No	Yes	No	Yes	No
D’Annibale et al^Citation16	2013	Italy	100	50	50	Yes	Yes	No	Yes	No
Erguner et al^Citation14	2013	Turkey	64	27	37	No	Yes	No	Yes	No
Park et al^Citation18	2015	South Korea	217	133	84	Yes	Yes	No	Yes	No
Pigazzi et al^Citation19	2006	US	12	6	6	Yes	Yes	No	Yes	No
Park et al^Citation20	2013	South Korea	80	40	40	No	Yes	No	Yes	No
Kim and Kang^Citation21	2010	South Korea	200	100	100	Yes	Yes	No	Yes	No
Serin et al^Citation22	2015	Turkey	79	14	65	Yes	Yes	No	No	No

Abbreviations: TME, total mesorectal excision; LAR, low anterior resection.

Figure 2 Funnel plot of blood loss outcome.

Abbreviations: SE, standard error; MD, mean difference.

Figure 3 Forest plot of blood loss outcome.

Abbreviations: SD, standard deviation; IV, inverse variance; CI, confidence interval.

Figure 4 Funnel plot of involvement of circumferential resection margin outcome.

Abbreviations: SE, standard error; RD, risk difference.

Figure 5 Forest plot of involvement of circumferential resection margin outcome.

Abbreviations: M–H, Mantel–Haenszel; CI, confidence interval.

Figure 6 Funnel plot of conversion rate outcome.

Abbreviations: SE, standard error; RD, risk difference.

Figure 7 Forest plot of conversion rate outcome.

Abbreviations: M–H, Mantel–Haenszel; CI, confidence interval.

Figure 8 Forest plot of days to first passing flatus outcome.

Abbreviations: SD, standard deviation; IV, inverse variance; CI, confidence interval.

Figure 9 Forest plot of length of hospital stay outcome.

Abbreviations: SD, standard deviation; IV, inverse variance; CI, confidence interval.

Figure 10 Forest plot of operative time outcome.

Abbreviations: SD, standard deviation; IV, inverse variance; CI, confidence interval.

Figure 11 Forest plot of postoperative complications outcome.

Abbreviations: M–H, Mantel–Haenszel; CI, confidence interval.

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