Robotic-assisted versus standard laparoscopic surgery for colorectal cancer in obese patients: a systematic review and meta-analysis

Colorectal cancer represents a major global health concern and obesity adds complicates its surgical management. This meta-analysis aimed to evaluate the comparative effectiveness and safety of robotic-assisted surgery and standard laparoscopic surgery in obese colorectal cancer patients. A comprehensive literature search performed across databases from inception to April 2024. Pooled estimates included hospital stay duration, drainage tube removal time, first ventilation time, complication rates, re-admission rates and re-operative rates. Six studies involving 4215 patients were included. Robotic-assisted surgery was associated with a statistically significant but modest reduction in hospital stay time compared to laparoscopic surgery (<i>p</i> = 0.02). No significant differences were found for drainage tube removal time (<i>p</i> = 0.42) and first ventilation time (<i>p</i> = 0.27). Complication rates (OR [odds ratio] = 0.92, 95% confidence interval [CI]: 0.74 to 1.13, <i>p</i> = 0.41), re-admission rates (OR = 0.81, 95% CI: 0.31 to 2.13, <i>p</i> = 0.67) and re-operative rates (OR = 1.20, 95% CI: 0.77 to 1.86, <i>p</i> = 0.41) did not significantly differ between surgical approaches. Robotic-assisted surgery significantly provides a modest reduction in hospital stay duration without compromising patient safety for obese colorectal cancer patients. These findings should be interpreted with caution. Future randomized controlled trials are required to confirm these results.