Robotic surgery for colorectal liver metastases (CRLM): A systematic literature review with meta-analysis.

Colorectal Cancer (CRC) is the third most prevalent cancer (10.2%) with the second highest mortality (9.2%).[1] Up to 14.5% of patients present with synchronous metastases and 12.8% will develop metachronous metastases within 5 years. The treatment for these metastases is resection. [2] In this study we perform a systematic search of the literature about robotic versus laparoscopic liver resections of colorectal liver metastases (CLRM). We include 16 studies. We describe the patient and tumor characteristics. We also describe operation characteristics (rate of major resections, operation time, usage and duration of Pringle, conversion rate, complication rate, R0 margin rate, estimated blood loss, length of stay, mortality and recurrence. Using this data we perform a meta-analysis: no significant difference in operation time was found between robotic and laparoscopic liver resections. There was significantly lower conversion rate, significantly higher R0 margin rate, significantly lower blood loss in the robotic group. We conclude that robotic surgery is promising in the therapy of CRLM. In the future there is need for RCT to compare robotic versus laparoscopic liver surgery for CRLM. Furthermore a longer follow-up is needed.