Colorectal cancer is the third most common cancer worldwide, and the liver is the most common localization of metastatic disease. The incidence of minimally invasive liver surgery is increasing, and robotic surgery (RLR) is believed to overcome some limitations of a laparoscopic approach (LRL). We performed a systematic review and meta-analysis of operative and short-term oncologic outcomes of the laparoscopic versus robotic-assisted liver resection for colorectal liver metastases. An online search of PubMed, Embase, Scopus, and the Cochrane databases was performed. Eight studies involving 3210 patients were considered eligible for the meta-analysis. In the LRL group, a higher conversion to open rate (12.4%) was observed compared to the RLR (6.7%;p= <0.001). 30-day mortality was 0.7% for the LRL group compared to 0.5% for the RLR group (p= 0.76). Mortality in longer periods among LLR and RLR amounted to 18.2% vs. 8.0% for 1-year mortality (p= 0.07), 34.1% vs. 26.7% for 2-year mortality (p= 0.13), and 52.3% vs. 48.3% for 3-year mortality (p= 0.46). The length of hospital stay was 5.6 ± 2.5 vs. 5.8 ± 2.1 days, respectively (p= 0.47). There were no significant differences between the incidence of individual complications in the LRL and RLR groups (p= 0.78). Laparoscopic or robotic approaches for colorectal liver metastases are comparable in terms of safety and effectiveness. There are significant advantages to robotic surgery, although there is still no long-term evidence concerning overall survival, and the number of patients operated on using RLR remains small.
结直肠癌是全球第三大常见癌症，肝脏是其最常见的转移部位。微创肝脏手术的应用日益广泛，机器人手术被认为能够克服腹腔镜手术的某些局限性。本研究对腹腔镜与机器人辅助肝切除术治疗结直肠癌肝转移的围手术期及短期肿瘤学结局进行了系统综述与荟萃分析。通过检索PubMed、Embase、Scopus及Cochrane数据库，最终纳入8项研究共3210例患者进行荟萃分析。结果显示，腹腔镜组中转开腹率（12.4%）显著高于机器人组（6.7%；p<0.001）。两组30天死亡率无显著差异（腹腔镜组0.7% vs 机器人组0.5%；p=0.76）。远期死亡率方面：1年死亡率腹腔镜组18.2% vs 机器人组8.0%（p=0.07），2年死亡率34.1% vs 26.7%（p=0.13），3年死亡率52.3% vs 48.3%（p=0.46）。平均住院时间分别为5.6±2.5天与5.8±2.1天（p=0.47）。两组并发症发生率无统计学差异（p=0.78）。研究表明，腹腔镜与机器人手术治疗结直肠癌肝转移在安全性和有效性方面具有可比性。机器人手术虽显示出显著优势，但目前仍缺乏长期总生存期证据，且接受机器人手术的患者数量有限。
肿瘤(癌症)患者之家