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A peer-reviewed article of this preprint also exists.
supplementary.zip (258.45KB )
This version is not peer-reviewed
Submitted:
04 December 2023
Posted:
05 December 2023
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Systematic Review 1 | Systematic Review 2 | Systematic Review 3 | |
---|---|---|---|
Primary source 1 | X | X | |
Primary source 2 | X | ||
Primary source 3 | X | X | X |
CCA (%) | Overlap Interpretation |
---|---|
0-5 | Slight |
6-10 | Moderate |
11-15 | High |
>15 | Very high |
Blood loss | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Author (year) | Ref. | Subgroup analysis | No. studies/participants | Participants RALS | Participants CLS | RE/FE | Mean Difference/Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 5/769 | 442 | 327 | RE | MD | -0.95 | [-3.69; 1.79] | 0% | None |
Roh et al. (2018) | [37] | all | 1/136 | 83 | 53 | FE | MD | -2.23 | [-49.84; 45.38] | N/A | Nonea |
Sun et al. (2018a) | [34] | SR vs ML | 2/258 | 129 | 129 | FE | OR | 1.63 | [0.40; 6.56] | 0% | None |
Conversion to open surgery rate | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 22/2771 | 1214 | 1557 | RE | RR | 0.53 | [0.26; 1.07] | 36% | None |
Roh et al. (2018) | [37] | all | 2/146 | 70 | 76 | FE | OR | 0.85 | [0.18; 4.05] | N/A | None |
Sun et al. (2018a) | [34] | SR vs ML | 6/1537 | 715 | 822 | FE | OR | 1.30 | [0.71; 2.37] | 0% | None |
Sun et al. (2018b) | [35] | SR vs SL | 5/301 | 139 | 162 | FE | OR | 0.52 | [0.14; 1.96] | 0% | None |
Hospitalization costs | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 6/1176 | 456 | 720 | RE | MD | 3246 | [2416; 4075] | 96% | CLS |
Sun et al. (2018a) | [34] | SR vs ML | 2/643 | 177 | 466 | RE | MD | 3510 | [310; 6710] | 99% | CLS |
Sun et al. (2018b) | [35] | SR vs SL | 2/196 | 89 | 107 | FE | MD | 3700 | [3610; 3790] | 0% | CLS |
Incisional hernia rate | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE | Risk Ratio / Odds Ratio / Risk Difference [95%-CI] | Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 7/1499 | 676 | 823 | RE | RR | 3.22 | [1.54; 6.76] | 0% | CLS |
Sun et al. (2018a) | [34] | SR vs ML | 4/1381 | 622 | 759 | FE | OR | 4.23 | [1.87; 9.58] | 0% | CLS |
Wang et al. (2021) | [36] | SR vs SL | 15/916 | 534 | 382 | FE | RD | 0.05 | [0.02; 0.07] | 0% | CLS |
Intraoperative complication rate | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | All | 13/422 | 211 | 211 | RE | RR | 0.95 | [0.60; 1.50] | 2% | None |
Sun et al. (2018b) | [35] | SR vs SL | 4/219 | 101 | 118 | FE | OR | 0.48 | [0.17; 1.39] | 0% | None |
Postoperative complication rate | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE | Risk Ratio / Odds Ratio / Risk Difference [95%-CI] | Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 16/1859 | 817 | 1042 | RE | RR | 0.78 | [0.40; 1.52] | 28% | None |
Roh et al. (2018) | [37] | all | 1/136 | 83 | 53 | RE | OR | 1.29 | [0.23; 7.31] | N/A | Nonea |
Sun et al. (2018a) | [34] | SR vs ML | 6/1536 | 714 | 822 | RE | OR | 1.11 | [0.35; 3.51] | 76% | None |
Sun et al. (2018b) | [35] | SR vs SL | 6/633 | 305 | 328 | FE | OR | 0.62 | [0.21; 1.86] | 0% | None |
Wang et al. (2021) | [36] | SR vs SL | 16/3161 | 1509 | 1652 | FE | RD | 0.01 | [-0.00; 0.03] | 44% | None |
Length of hospital stay (days) | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 17/3514 | 1602 | 1912 | RE | MD | -0.20 | [-0.49; 0.08] | 92% | None |
Roh et al. (2018) | [37] | all | 3/216 | 123 | 93 | RE | MD | 0.07 | [-0.28; 0.42] | 0% | None |
Sun et al. (2018a) | [34] | SR vs ML | 4/1441 | 652 | 789 | RE | MD | -0.02 | [-0.60; 0.57] | 93% | None |
Sun et al. (2018b) | [35] | SR vs SL | 4/521 | 247 | 274 | FE | MD | -0.01 | [-0.21; 0.19] | 0% | None |
Operative time (min) | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 21/3640 | 1653 | 1987 | RE | MD | 13.14 | [4.97; 21.50] | 94% | CLS |
Roh et al. (2018) | [37] | all | 4/302 | 163 | 139 | RE | MD | 10.09 | [-6.04; 26.21] | 85% | None |
Sun et al. (2018a) | [34] | SR vs ML | 2/697 | 424 | 273 | FE | MD | -3.06 | [-7.61; 1.49] | 0% | None |
Sun et al. (2018b) | [35] | SR vs SL | 5/551 | 267 | 284 | RE | MD | 17.32 | [-8.93; 43.57] | 97% | None |
30-day readmission rate | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Han et al. (2018) | [33] | all | 6/1420 | 811 | 609 | RE | RR | 1.21 | [0.62; 2.35] | 0% | None |
Sun et al. (2018b) | [35] | SR vs SL | 3/412 | 211 | 201 | FE | OR | 0.70 | [0.09; 5.63] | 0% | None |
Wound infection rate | |||||||||||
Author (year) | Ref. | Subgroup analysis | No. studies / participants | Participants RALS | Participants CLS | RE / FE | Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Sun et al. (2018a) | [34] | SR vs ML | 4/1319 | 606 | 713 | FE | OR | 1.92 | [0.86; 4.32] | 18% | None |
Blood loss | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE | (Standardized) Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Bianchi et al. (2022) | [40] | proctocolectomy, proctectomy | 3/194 | 105 | 89 | RE | MD | 57.99 | [-65.20; 181.17] | 81% | None |
Sheng et al. (2018) | [41] | - | 40/12825 | 129 | 6749 | RE | MD | -21.12 | [-175.07; 33.17] | N/A | None |
Cuk et al. (2022) | [43] | - | 7/635 | 218 | 417 | RE | MD | -0.33 | [-16.54; 15.88] | 75% | None |
Flynn et al. (2022) | [46] | total mesorectal excision | 30/- | N/A | N/A | RE | SMD | -0.12 | [-0.32; 0.08] | 93% | None |
Gavriilidis et al. (2020) | [47] | total mesorectal excision | 16/3210 | N/A | N/A | RE | MD | 10.48 | [-15.50; 36.46] | 84% | None |
Jones et al. (2018) | [31] | total mesorectal excision | 18/3002 | 1393 | 1609 | RE | SMD | -0.10 | [-0.26; 0.05] | 74% | None |
Roh et al. (2018) | [37] | - | 2/136 | 64 | 72 | FE | MD | -20.10 | [-33.44; -6.75] | 0% | RALS |
Solaini et al. (2022) | [50] | left hemicolectomy | 3/411 | 118 | 293 | RE | MD | -19.77 | [-39.10; -0.43] | 79% | RALS |
Genova et al. (2021) | [51] | right hemicolectomy | 15/1413 | 536 | 877 | RE | MD | -12.14 | [-19.08; -5.20] | 18% | RALS |
Lauka et al. (2020) | [52] | right hemicolectomy | 13/1379 | 523 | 856 | RE | MD | -8.68 | [-17.27; -0.08] | 46% | RALS |
Ma et al. (2019) | [53] | right hemicolectomy | 8/694 | 234 | 460 | FE | MD | -16.89 | [-24.80; -8.98] | 35% | RALS |
Rausa et al. (2019) | [54] | right hemicolectomy | -/- | N/A | N/A | RE | MD | 0.40 | [-28.00; 28.00] | 89% | None |
Solaini et al. (2018) | [55] | right hemicolectomy | 8/888 | N/A | N/A | N/A | SMD | -0.19 | [-0.51; 0.12] | 77% | None |
Tschann et al. (2022) | [56] | right hemicolectomy | 12/- | N/A | N/A | RE | MD | -10.03 | [-18.45; -1.61] | 65% | RALS |
Zhu et al. (2021) | [58] | right hemicolectomy | 5/454 | 194 | 260 | FE | MD | -13.43 | [-20.65; -6.21] | 33% | RALS |
Conversion to open surgery rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE / CMH |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Larkins et al. (2022) | [39] | diverticular resection | 8/13190 | 3182 | 10008 | RE | OR | 0.57 | [0.49; 0.66] | 0% | RALS |
Bianchi et al. (2022) | [40] | sub(total) colectomy | 3/10042 | 364 | 9678 | RE | OR | 0.17 | [0.04; 0.82] | 38% | RALS |
Bianchi et al. (2022) | [40] | proctocolectomy, proctectomy | 4/240 | 128 | 112 | RE | OR | 0.45 | [0.09; 2.26] | 0% | None |
Giuliani et al. (2022) | [42] | - | 9/3927 | 1922 | 2005 | FE | OR | 0.56 | [0.45; 0.70] | 31% | RALS |
Cuk et al. (2022) | [43] | - | 17/10906 | 1554 | 9352 | FE | OR | 0.31 | [0.23; 0.41] | 41% | RALS |
Flynn et al. (2022) | [46] | total mesorectal excision | 44/9799 | 4476 | 5323 | CMH | OR | 0.34 | [0.27; 0.43] | 0% | RALS |
Gavriilidis et al. (2020) | [47] | total mesorectal excision | 17/3381 | N/A | N/A | FE | OR | 0.26 | [0.17; 0.38] | 0% | RALS |
Jones et al. (2018) | [31] | total mesorectal excision | 24/4961 | 2379 | 2582 | RE | OR | 0.40 | [0.29; 0.55] | 0% | RALS |
Roh et al. (2018) | [37] | - | 4/226 | 110 | 116 | FE | OR | 0.25 | [0.07; 0.91] | 24% | RALS |
Solaini et al. (2022) | [50] | left hemicolectomy | 9/52058 | 13281 | 38777 | RE | RR | 0.53 | [0.50; 0.57] | 0% | RALS |
Genova et al. (2021) | [51] | right hemicolectomy | 28/13057 | 1777 | 11280 | RE | OR | 0.46 | [0.34; -0.63] | 0% | RALS |
Lauka et al. (2020) | [52] | right hemicolectomy | 21/9324 | 1519 | 7805 | RE | RR | 0.47 | [0.27; 0.81] | 33% | RALS |
Ma et al. (2019) | [53] | right hemicolectomy | 9/800 | 336 | 464 | FE | OR | 0.34 | [0.15; 0.75] | 0% | RALS |
Rausa et al. (2019) | [54] | right hemicolectomy | -/- | N/A | N/A | RE | RR | 1.70 | [0.53; 5.90] | 23% | None |
Solaini et al. (2018) | [55] | right hemicolectomy | 10/7843 | N/A | N/A | N/A | RR | 0.59 | [0.38; 0.91] | 5% | RALS |
Tschann et al. (2022) | [56] | right hemicolectomy | 19/- | N/A | N/A | RE | OR | 0.65 | [0.46; 0.93] | 14% | RALS |
Zhu et al. (2021) | [58] | right hemicolectomy | 9/1084 | 488 | 596 | FE | OR | 0.30 | [0.17; 0.54] | 43% | RALS |
Hospitalization costs | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
(Standardized) Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Roh et al. (2018) | [37] | - | 1/70 | 35 | 35 | RE | MD | 1.92 | [1.09; 2.74] | N/A | CLSc |
Genova et al. (2021) | [51] | right hemicolectomy | 9/8660 | 875 | 7785 | RE | MD | 2589.46 | [972.72; 4206.21] | 94% | CLS |
Lauka et al. (2020) | [52] | right hemicolectomy | 6/528 | 206 | 322 | RE | MD | 3185.50 | [720.98; 5650.02] | 95% | CLS |
Rausa et al. (2019) | [54] | right hemicolectomy | 4/- | N/A | N/A | RE | SMD | 0.60 | [0.33; 0.86] | 66% | CLS |
Solaini et al. (2018) | [55] | right hemicolectomy | 5/659 | N/A | N/A | N/A | SMD | 0.52 | [0.04; 1.00] | 84% | CLS |
Tschann et al. (2022) | [56] | right hemicolectomy | 5/- | N/A | N/A | RE | MD | 2660 | [150; 5170] | 96% | CLS |
Incisional hernia rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Ravindra et al. (2022) | [44] | - | 2/684 | 342 | 342 | RE | RR | 0.93 | [0.05; 17.20] | 60% | None |
Genova et al. (2021) | [51] | right hemicolectomy | 6/985 | 346 | 639 | RE | OR | 0.63 | [0.33; 1.19] | 0% | None |
Solaini et al. (2018) | [55] | right hemicolectomy | 5/708 | N/A | N/A | N/A | RR | 0.38 | [0.07; 2.50] | 0% | None |
Tschann et al. (2022) | [56] | right hemicolectomy | 3/- | N/A | N/A | RE | OR | 0.66 | [0.35; 1.28] | 0% | None |
Intraoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Roh et al. (2018) | [37] | - | 1/34 | 18 | 16 | FE | OR | 4.29 | [0.43; 43.14] | N/A | Nonec |
Postoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE / CMH |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Larkins et al. (2022) | [39] | diverticular resection | 6/1384 | 663 | 721 | RE | OR | 0.74 | [0.49; 1.13] | 0% | None |
Bianchi et al. (2022) | [40] | (sub)total colectomy | 3/10042 | 364 | 9678 | RE | OR | 0.86 | [0.54; 1.38] | 19% | None |
Bianchi et al. (2022) | [40] | proctocolectomy, proctectomy | 5/345 | 161 | 184 | RE | OR | 0.66 | [0.22; 1.73] | 0% | None |
Sheng et al. (2018) | [41] | - | 40/12825 | 129 | 6749 | RE | OR | 0.79 | [0.28; 2.13] | N/A | None |
Giuliani et al. (2022) | [42] | - | 8/1453 | 686 | 767 | FE | OR | 0.76 | [0.58; 1.01] | 0% | None |
Cuk et al. (2022) | [43] | - | 20/13799 | 1740 | 12059 | FE | OR | 0.85 | [0.73; 1.00] | 10% | RALS |
Flynn et al. (2022) | [46] | total mesorectal excision | 43/9520 | 4317 | 5203 | CMH | OR | 0.84 | [0.76; 0.92] | 47% | RALS |
Jones et al. (2018) | [31] | total mesorectal excision | 21/4833 | 2315 | 2518 | RE | OR | 0.92 | [0.75; 1.12] | 39% | None |
Rausa et al. (2019) | [48] | total mesorectal excision | 22/- | N/A | N/A | RE | RR | 1.10 | [0.91; 1.30] | 0% | None |
Flynn et al. (2021) | [49] | proctocolectomy with IPAA | 4/240 | 128 | 112 | CMH | OR | 0.65 | [0.38; 1.12] | 0% | None |
Solaini et al. (2022) | [50] | left hemicolectomy | 10/52061 | 13330 | 38731 | RE | RR | 0.86 | [0.83; 0.90] | 0% | RALS |
Lauka et al. (2020) | [52] | right hemicolectomy | 16/- | N/A | N/A | RE | RR | 0.91 | [0.80; 1.04] | 0% | None |
Ma et al. (2019) | [53] | right hemicolectomy | 11/961 | 402 | 559 | FE | OR | 0.73 | [0.52; 1.01] | 1% | RALS |
Rausa et al. (2019) | [54] | right hemicolectomy | -/- | N/A | N/A | RE | RR | 1.00 | [0.66; 1.50] | 20% | None |
Solaini et al. (2018) | [55] | right hemicolectomy | 10/7843 | N/A | N/A | N/A | RR | 0.95 | [0.50; 1.11] | 0% | None |
Zhu et al. (2021) | [58] | right hemicolectomy | 5/854 | 383 | 471 | FE | OR | 0.83 | [0.60; 1.14] | 0% | None |
Length of hospital stay (days) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
(Standardized) Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Bianchi et al. (2022) | [40] | (sub)total colectomy | 2/102 | 38 | 64 | RE | MD | -1.86 | [-3.99; 0.26] | 0% | None |
Bianchi et al. (2022) | [40] | proctocolectomy, proctectomy | 4/299 | 138 | 161 | RE | MD | -0.13 | [-1.80; 2.06] | 70% | None |
Sheng et al. (2018) | [41] | - | 40/12825 | 129 | 6749 | RE | MD | -0.34 | [-2.93; 2.21] | N/A | None |
Giuliani et al. (2022) | [42] | - | 7/1426 | 683 | 743 | FE | SMD | -0.21 | [-0.32; -0.11] | 45% | RALS |
Cuk et al. (2022) | [43] | - | 17/4626 | 981 | 3645 | RE | MD | -0.58 | [-1.37; 0.21] | 91% | None |
Ravindra et al. (2022) | [44] | - | 12/1973 | 872 | 1101 | FE | SMD | -0.10 | [-0.19; -0.01] | 0% | RALS |
Flynn et al. (2022) | [46] | total mesorectal excision | 39/- | N/A | N/A | RE | SMD | -0.22 | [-0.33; -0.11] | 83% | RALS |
Gavriilidis et al. (2020) | [47] | total mesorectal excision | 23/4509 | N/A | N/A | RE | MD | -0.58 | [-1.24; 0.09] | 68% | None |
Jones et al. (2018) | [31] | total mesorectal excision | 24/5010 | 2409 | 2601 | RE | SMD | -0.15 | [-0.27; -0.03] | 74% | RALS |
Roh et al. (2018) | [37] | - | 4/226 | 110 | 116 | RE | MD | -0.54 | [-2.16; 1.08] | 54% | None |
Solaini et al. (2022) | [50] | left hemicolectomy | 9/52333 | 13378 | 38955 | RE | MD | -0.28 | [-0.63; 0.06] | 89% | None |
Genova et al. (2021) | [51] | right hemicolectomy | 34/16010 | 2059 | 13951 | RE | MD | -0.50 | [-0.85; -0.15] | 58% | RALS |
Lauka et al. (2020) | [52] | right hemicolectomy | 22/4945 | 1218 | 3727 | RE | MD | -0.60 | [-1.01; -0.19] | 64% | RALS |
Ma et al. (2019) | [53] | right hemicolectomy | 10/7535 | 534 | 7001 | RE | MD | -0.61 | [-1.15; -0.06] | 52% | RALS |
Rausa et al. (2019) | [54] | right hemicolectomy | -/- | N/A | N/A | RE | MD | 2.90 | [-0.70; 6.50] | 80% | None |
Solaini et al. (2018) | [55] | right hemicolectomy | 10/7968 | N/A | N/A | N/A | SMD | -0.09 | [-0.30; 0.06] | 67% | None |
Tschann et al. (2022) | [56] | right hemicolectomy | 20/- | N/A | N/A | RE | MD | -0.84 | [-1.38; -0.29] | 87% | RALS |
Zhu et al. (2021) | [58] | right hemicolectomy | 4/442 | 188 | 254 | FE | MD | -0.23 | [-0.73; 0.28] | 0% | None |
Operative time (min) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE | (Standardized) Mean Difference / Hedge’s G [95%-CI] | Heterogeneity (I2) | Favours | ||
Larkins et al. (2022) | [39] | diverticular resection | 6/3675 | 1812 | 1863 | RE | HG | 0.43 | [0.04; 0.81] | 95% | CLS |
Bianchi et al. (2022) | [40] | (sub)total colectomy | 2/102 | 38 | 64 | RE | MD | 104.64 | [18.42; 190.87] | 58% | CLS |
Bianchi et al. (2022) | [40] | proctocolectomy, proctectomy | 4/299 | 138 | 161 | RE | MD | 38.88 | [18.70; 59.06] | 36% | CLS |
Sheng et al. (2018) | [41] | - | 40/12825 | 129 | 6749 | RE | MD | 65.69 | [38.01; 94.10] | N/A | CLS |
Giuliani et al. (2022) | [42] | - | 8/1453 | 686 | 767 | FE | SMD | 0.49 | [0.38; 0.60] | 94% | CLS |
Cuk et al. (2022) | [43] | - | 19/5184 | 1229 | 3955 | RE | MD | 42.99 | [28.37; 57.60] | 97% | CLS |
Flynn et al. (2022) | [46] | total mesorectal excision | 41/- | N/A | N/A | RE | SMD | 0.82 | [0.60; 1.04] | 96% | CLS |
Gavriilidis et al. (2020) | [47] | total mesorectal excision | 26/4734 | N/A | N/A | RE | MD | 50.35 | [31.70; 70.69] | 97% | CLS |
Jones et al. (2018) | [31] | total mesorectal excision | 27/5449 | 2601 | 2848 | RE | SMD | 0.65 | [0.43; 0.87] | 93% | CLS |
Roh et al. (2018) | [37] | - | 4/226 | 110 | 116 | RE | MD | 23.83 | [-11.87; 59.53] | 94% | None |
Solaini et al. (2022) | [50] | left hemicolectomy | 10/52439 | 13438 | 39001 | RE | MD | 39.08 | [17.26; 60.91] | 97% | CLS |
Genova et al. (2021) | [51] | right hemicolectomy | 35/16292 | 2178 | 14114 | RE | MD | 56.43 | [45.43; 67.43] | 91% | CLS |
Lauka et al. (2020) | [52] | right hemicolectomy | 22/11664 | 1523 | 10141 | RE | MD | 45.36 | [31.75; 58.97] | 95% | CLS |
Ma et al. (2019) | [53] | right hemicolectomy | 12/7740 | 656 | 7084 | RE | MD | 43.60 | [26.71; 60.48] | 92% | CLS |
Rausa et al. (2019) | [54] | right hemicolectomy | -/- | N/A | N/A | RE | MD | -24.00 | [-70.00; 21.00] | 90% | None |
Solaini et al. (2018) | [55] | right hemicolectomy | 11/8257 | 869 | 7388 | N/A | SMD | 0.99 | [0.60; 1.40] | 95% | CLS |
Tschann et al. (2022) | [56] | right hemicolectomy | 22/- | N/A | N/A | RE | MD | 42.01 | [32.96; 51.06] | 89% | CLS |
Zhu et al. (2021) | [58] | right hemicolectomy | 6/522 | 255 | 267 | RE | MD | 65.20 | [53.40; 77.01] | 55% | CLS |
30-day readmission rate | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE / CMH | Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Ravindra et al. (2022) | [44] | - | 7/797 | 327 | 470 | FE | RR | 0.89 | [0.50; 1.60] | 6% | None |
Gavriilidis et al. (2020) | [47] | total mesorectal excision | 4/508 | N/A | N/A | FE | OR | 1.17 | [0.54; 2.56] | 68% | None |
Flynn et al. (2021) | [49] | proctocolectomy with IPAA | 3/207 | 112 | 95 | CMH | OR | 0.73 | [0.35; 1.55] | 0% | None |
Genova et al. (2021) | [51] | right hemicolectomy | 12/8691 | 1072 | 7619 | RE | OR | 0.98 | [0.53; 1.82] | 38% | None |
Wound infection rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Sheng et al. (2018) | [41] | - | 40/12825 | 129 | 6749 | RE | OR | 1.09 | [0.11; 8.45] | N/A | None |
Cuk et al. (2022) | [43] | - | 15/4598 | 940 | 3658 | FE | OR | 0.81 | [0.55; 1.20] | 0% | None |
Ravindra et al. (2022) | [44] | - | 11/1796 | 822 | 974 | FE | RR | 1.00 | [0.65; 1.53] | 0% | None |
Rausa et al. (2019) | [48] | total mesorectal excision | 17/- | N/A | N/A | RE | RR | 1.50 | [0.86; 2.60] | 0% | None |
Solaini et al. (2022) | [50] | left hemicolectomy | 8/51445 | 13061 | 38384 | RE | RR | 0.78 | [0.70; 0.87] | 0% | RALS |
Solaini et al. (2018) | [55] | right hemicolectomy | 8/7698 | N/A | N/A | N/A | RR | 0.67 | [0.42; 1.11] | 0% | None |
Tschann et al. (2022) | [56] | right hemicolectomy | 16/- | N/A | N/A | RE | OR | 0.87 | [0.64; 1.19] | 0% | None |
Zhu et al. (2021) | [58] | right hemicolectomy | 5/709 | 329 | 380 | FE | OR | 0.65 | [0.34; 1.25] | 0% | None |
Blood loss | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE | Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Prodromidou et al. (2020) | [60] | single-site hysterectomy | 5/287 | 125 | 162 | RE | MD | -10.84 | [-20.35; -1.32] | 55% | RALS |
Kampers et al. (2022) | [61] | radical hysterectomy | 5/343 | 139 | 204 | RE | MD | -30.89 | [-114.46; 52.69] | - | None |
Marchand et al. (2021) | [62] | - | 2/196 | 111 | 85 | FE | MD | -85.27 | [-124.09; -46.45] | 0% | RALS |
Zhang et al. (2019) | [63] | radical hysterectomy | 8/640 | 283 | 357 | RE | MD | -22.25 | [-81.38; 36.87] | 89% | None |
Jin et al. (2018) | [65] | radical hysterectomy | 5/- | N/A | N/A | RE | MD | -40.39 | [-117.75; 35.97] | 96% | None |
Lawrie et al. (2019) | [29] | - | 1/95 | 47 | 48 | RE | MD | 7.00 | [-18.26; 32.26] | N/A | Noned |
Roh et al. (2018) | [37] | - | 5/478 | 235 | 243 | FE | MD | -5.57 | [-8.81; -2.32] | 14% | RALS |
Conversion to open surgery rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Zhang et al. (2019) | [63] | radical hysterectomy | 3/176 | 98 | 78 | RE | OR | 0.66 | [0.09; 4.67] | 30% | None |
Lawrie et al. (2019) | [29] | - | 3/269 | 134 | 135 | RE | RR | 1.17 | [0.24; 5.77] | 0% | None |
Roh et al. (2018) | [37] | - | 4/368 | 184 | 184 | FE | OR | 0.46 | [0.15; 1.44] | 33% | None |
Hospitalization costs | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Lawrie et al. (2019) | [29] | - | 1/97 | 61 | 36 | RE | MD | 1564.00 | [1079.57; 2048.43] | N/A | CLSd |
Roh et al. (2018) | [37] | - | 1/74 | 38 | 36 | RE | MD | 0.09 | [-0.43; 0.61] | N/A | Noned |
Intraoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Marchand et al. (2021) | [62] | - | 4/708 | 359 | 349 | RE | RR | 1.15 | [0.30; 4.35] | 36% | None |
Zhang et al. (2019) | [63] | radical hysterectomy | 7/588 | 249 | 339 | RE | OR | 1.17 | [0.44; 3.10] | 0% | None |
Jin et al. (2018) | [65] | radical hysterectomy | 3/- | N/A | N/A | FE | OR | 0.83 | [0.16; 4.34] | 63% | None |
Hwang et al. (2020) | [66] | radical hysterectomy | 23/2855 | 986 | 1869 | FE | OR | 0.86 | [0.48; 1.55] | 0% | None |
Lawrie et al. (2019) | [29] | - | 5/487 | 256 | 231 | RE | RR | 1.05 | [0.31; 3.56] | 28% | None |
Roh et al. (2018) | [37] | - | 3/316 | 158 | 158 | FE | OR | 1.11 | [0.48; 2.53] | 48% | None |
Postoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Marchand et al. (2021) | [62] | - | 4/708 | 359 | 349 | RE | RR | 0.93 | [0.50; 1.75] | 59% | None |
Zhang et al. (2019) | [63] | radical hysterectomy | 9/678 | 305 | 373 | RE | OR | 0.66 | [0.39; 1.12] | 31% | None |
Jin et al. (2018) | [65] | radical hysterectomy | 2/- | N/A | N/A | FE | OR | 0.42 | [0.20; 0.87] | 0% | RALS |
Hwang et al. (2020) | [66] | radical hysterectomy | 23/2855 | 986 | 1869 | FE | OR | 0.94 | [0.64; 1.38] | 0% | None |
Lawrie et al. (2019) | [29] | - | 5/533 | 291 | 242 | RE | RR | 0.82 | [0.42; 1.59] | 51% | None |
Roh et al. (2018) | [37] | - | 3/316 | 158 | 158 | RE | OR | 0.96 | [0.28; 3.25] | 72% | None |
Length of hospital stay (days) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Prodromidou et al. (2020) | [60] | single-site hysterectomy | 4/328 | 119 | 209 | RE | MD | -0.32 | [-0.44; -0.19] | 0% | RALS |
Kampers et al. (2022) | [61] | radical hysterectomy | 5/343 | 139 | 204 | RE | MD | -0.96 | [-2.33; 0.41] | - | None |
Marchand et al. (2021) | [62] | - | 3/246 | 136 | 110 | RE | MD | -1.20 | [-2.01; -0.38] | 91% | RALS |
Zhang et al. (2019) | [63] | radical hysterectomy | 9/678 | 305 | 373 | RE | MD | -0.24 | [-1.33; 0.85] | 87% | None |
Jin et al. (2018) | [65] | radical hysterectomy | 4/- | N/A | N/A | RE | MD | -1.01 | [-2.82; 0.80] | 92% | None |
Lawrie et al. (2019) | [29] | - | 2/192 | 108 | 84 | RE | MD | -0.30 | [-0.53; -0.07] | 0% | RALS |
Roh et al. (2018) | [37] | - | 5/425 | 212 | 213 | RE | MD | -0.56 | [-1.04; -0.09] | 73% | RALS |
Operative time (min) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Kampers et al. (2022) | [61] | radical hysterectomy | 5/343 | 139 | 204 | RE | MD | 30.84 | [-0.72; 62.40] | - | None |
Zhang et al. (2019) | [63] | radical hysterectomy | 9/678 | 305 | 373 | RE | MD | 18.10 | [-14.94; 51.13] | 93% | None |
Jin et al. (2018) | [65] | radical hysterectomy | 5/- | N/A | N/A | RE | MD | -8.24 | [-61.56; 45.07] | 97% | None |
Lawrie et al. (2019) | [29] | - | 2/148 | 73 | 75 | RE | MD | 41.18 | [-6.17; 88.53] | 80% | None |
Roh et al. (2018) | [37] | - | 5/410 | 205 | 205 | RE | MD | -1.24 | [-32.57; 30.09] | 95% | None |
30-day readmission rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Lawrie et al. (2019) | [29] | - | 2/220 | 122 | 98 | RE | RR | 0.46 | [0.14; 1.48] | 0% | None |
Wound infection rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Marchand et al. (2021) | [62] | - | 3/340 | 183 | 157 | FE | RR | 1.43 | [0.50; 4.00] | 0% | None |
Lawrie et al. (2019) | [29] | - | 4/367 | 195 | 172 | RE | RR | 0.62 | [0.13; 2.88] | 2% | None |
Blood loss | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE | Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2020) | [69] | - | 6/1372 | 532 | 840 | RE | MD | 1.83 | [-18.61; 22.27] | 74% | None |
Crocerossa et al. (2021) | [70] | radical nephrectomy | 5/1135 | 511 | 624 | RE | MD | 2.18 | [-26.69; 31.04] | 84% | None |
Wang et al. (2019) | [71] | donor nephrectomy | 4/324 | 130 | 194 | FE | MD | 28.30 | [10.24; 46.37] | 0% | CLS |
Sharma et al. (2022) | [72] | partial nephrectomy | 5/969 | N/A | N/A | RE | MD | -16.98 | [-52.03; 18.08] | 80% | None |
Xiao et al. (2020) | [73] | donor nephrectomy | -/- | N/A | N/A | N/A | MD | 2.60 | [-52.57; 55.09] | N/A | None |
Conversion to open surgery rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2020) | [69] | - | 4/1334 | 516 | 813 | RE | OR | 2.67 | [0.69; 10.33] | 51% | None |
Wang et al. (2019) | [71] | donor nephrectomy | 2/190 | 96 | 94 | RE | OR | 0.57 | [0.11; 2.93] | 0% | None |
Hospitalization costs | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Crocerossa et al. (2021) | [70] | radical nephrectomy | 4/50990 | 13296 | 37694 | RE | MD | 4.70 | [3.58; 5.82] | 67% | CLS |
Intraoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2020) | [69] | - | 4/- | N/A | N/A | RE | OR | 1.13 | [0.61; 2.12] | 51% | None |
Crocerossa et al. (2021) | [70] | radical nephrectomy | 4/7138 | 5421 | 1717 | RE | OR | 1.01 | [0.17; 6.03] | 95% | None |
Sharma et al. (2022) | [72] | partial nephrectomy | 3/- | N/A | N/A | FE | OR | 0.57 | [0.27; 1.22] | 0% | None |
Xiao et al. (2020) | [73] | donor nephrectomy | -/- | N/A | N/A | N/A | OR | 22.5 | [1.59; 630.10] | N/A | CLS |
Postoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2020) | [69] | - | 6/- | N/A | N/A | FE | OR | 1.07 | [0.68; 1.67] | 0% | None |
Crocerossa et al. (2021) | [70] | radical nephrectomy | 7/33397 | 10617 | 22780 | RE | OR | 0.93 | [0.70; 1.23] | 83% | None |
Wang et al. (2019) | [71] | donor nephrectomy | 5/369 | 145 | 224 | FE | OR | 1.12 | [0.52; 2.44] | 0% | None |
Xiao et al. (2020) | [73] | donor nephrectomy | -/- | N/A | N/A | N/A | OR | 1.15 | [0.44; 3.07] | N/A | None |
Length of hospital stay (days) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2020) | [69] | - | 7/1832 | 762 | 1070 | RE | MD | -0.34 | [-0.68; -0.00] | 85% | None |
Crocerossa et al. (2021) | [70] | radical nephrectomy | 7/26100 | 8528 | 17572 | RE | MD | -0.84 | [-1.52; -0.16] | 99% | RALS |
Wang et al. (2019) | [71] | donor nephrectomy | 7/514 | 250 | 264 | RE | MD | -6.79 | [-17.25; 3.66] | 81% | None |
Sharma et al. (2022) | [72] | partial nephrectomy | 5/969 | N/A | N/A | RE | MD | -0.36 | [-1.04; 0.32] | 93% | None |
Xiao et al. (2020) | [73] | donor nephrectomy | -/- | N/A | N/A | N/A | MD | -0.01 | [-0.66; 0.69] | N/A | None |
Roh et al. (2018) | [37] | - | 1/45 | 15 | 30 | RE | MD | -1.00 | [-1.38; -0.62] | N/A | RALSe |
Operative time (min) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
(Standardized) Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2020) | [69] | - | 6/1372 | 532 | 840 | RE | MD | 29.05 | [-0.31; 58.41] | 93% | None |
Crocerossa et al. (2021) | [70] | radical nephrectomy | 5/1328 | 511 | 817 | RE | MD | 37.44 | [3.94; 70.94] | 94% | CLS |
Wang et al. (2019) | [71] | donor nephrectomy | 7/510 | 249 | 261 | RE | SMD | 0.53 | [0.20; 0.85] | 59% | CLS |
Sharma et al. (2022) | [72] | partial nephrectomy | 5/969 | N/A | N/A | RE | MD | -11.74 | [-38.17; 14.69] | 93% | None |
Xiao et al. (2020) | [73] | donor nephrectomy | -/- | N/A | N/A | N/A | MD | 16.06 | [-13.46; 46.82] | N/A | None |
Roh et al. (2018) | [37] | - | 1/45 | 15 | 30 | RE | MD | 15.87 | [-4.79; 36.53] | N/A | Nonee |
Blood loss | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE | (Standardized) Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Du et al. (2018) | [59] | radical prostatectomy | 5/3185 | 1466 | 1692 | RE | SMD | -0.31 | [-0.61; -0.01] | 87% | RALS |
Carbonara et al. (2021) | [74] | radical prostatectomy | 10/4722 | 2328 | 2394 | RE | MD | -53.19 | [-116.11; 9.74] | 97% | None |
Wang et al. (2019) | [75] | radical prostatectomy | 9/1914 | 912 | 1002 | RE | SMD | -0.38 | [-0.84; 0.08] | 95% | None |
Pandolfo et al. (2022) | [76] | simple prostatectomy | 5/2006 | 828 | 1178 | RE | MD | -23.33 | [-85.93; 39.27] | 89% | None |
Roh et al. (2018) | [37] | - | 1/120 | 60 | 60 | FE | MD | -32.10 | [-81.36; 17.16] | N/A | Nonef |
Conversion to open surgery rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2022) | [77] | simple prostatectomy | 4/1878 | 728 | 1150 | RE | OR | 0.89 | [0.55; 1.45] | 0% | None |
Roh et al. (2018) | [37] | - | 1/112 | 52 | 60 | FE | OR | 2.00 | [0.61; 6.55] | N/A | Nonef |
Intraoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Li et al. (2022) | [77] | simple prostatectomy | 5/1928 | 753 | 1175 | RE | OR | 1.16 | [0.70; 1.92] | 0% | None |
Postoperative complication rate | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Risk Ratio / Odds Ratio [95%-CI] |
Heterogeneity (I2) | Favours | ||
Carbonara et al. (2021) | [74] | radical prostatectomy | 9/5585 | 3048 | 2537 | RE | OR | 1.03 | [0.78; 1.34] | 37% | None |
Wang et al. (2019) | [75] | radical prostatectomy | 8/5155 | 3975 | 1180 | RE | OR | 0.61 | [0.46; 0.81] | 35% | RALS |
Pandolfo et al. (2022) | [76] | simple prostatectomy | 5/2006 | 828 | 1178 | RE | RR | 1.66 | [0.94; 2.91] | 66% | None |
Li et al. (2022) – minor compl. | [77] | simple prostatectomy | 3/1810 | 696 | 1114 | RE | OR | 2.22 | [0.96; 5.00] | 72% | None* |
Li et al. (2022) – major compl. | [77] | simple prostatectomy | 3/1810 | 696 | 1114 | RE | OR | 2.38 | [0.99; 5.56] | 15% | None* |
Length of hospital stay (days) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Pandolfo et al. (2022) | [76] | simple prostatectomy | 4/1767 | 674 | 1093 | RE | MD | -1.44 | [-2.48; -0.40] | 97% | RALS |
Li et al. (2022) | [77] | simple prostatectomy | 4/1767 | 674 | 1093 | RE | MD | -1.20 | [-2.32; -0.09] | 99% | RALS |
Operative time (min) | |||||||||||
Author (year) | Ref. | Surgical specifications | No. studies / participants | Participants RALS | Participants CLS | RE / FE |
(Standardized) Mean Difference [95%-CI] |
Heterogeneity (I2) | Favours | ||
Du et al. (2018) | [59] | radical prostatectomy | 7/4604 | 1795 | 2809 | RE | SMD | -0.71 | [-1.25; -0.18] | 97% | RALS |
Carbonara et al. (2021) | [74] | radical prostatectomy | 9/3541 | 2190 | 1351 | RE | MD | -16.36 | [-46.33; 13.60] | 99% | None |
Pandolfo et al. (2022) | [76] | simple prostatectomy | 5/2003 | 828 | 1175 | RE | MD | 19.14 | [-4.12; 42.39] | 95% | None |
Li et al. (2022) | [77] | simple prostatectomy | 5/1928 | 753 | 1175 | RE | MD | 24.34 | [-0.82; 49.50] | 96% | None |
Roh et al. (2018) | [37] | - | 1/120 | 60 | 60 | RE | MD | 8.90 | [-1.27; 19.07] | N/A | Nonef |
Category | Blood loss | Conversion rate | Hospitalization costs | Incisional Hernia Rate | Intraoperative complication rate | Postoperative complication rate | Length of hospital stay | Operative time | Readmission rate | Wound infection rate |
---|---|---|---|---|---|---|---|---|---|---|
Cholecystectomy | None | None | CLS | CLS | None | None | None | CLS/None | None | None |
Colectomy | RALS/None | RALS | CLS | None | None | None | RALS/None | CLS | None | None |
Hysterectomy | RALS/None | None | CLS | - | None | None | RALS/None | None | None | None |
Nephrectomy | None | None | - | - | None | None | RALS/None | CLS/None | - | - |
Prostatectomy | None | None | CLS | - | None | None | RALS | None | - | - |
General | None | None | CLS | - | None | None | RALS | CLS | None | None |
Surgical category | N | r | c | CCA score |
---|---|---|---|---|
Cholecystectomy | 197 | 161 | 7 | 3.7% |
Colectomy | 556 | 354 | 23 | 2.6% |
Hysterectomy | 186 | 148 | 10 | 2.9% |
Nephrectomy | 248 | 223 | 9 | 1.4% |
Prostatectomy | 195 | 160 | 8 | 3.1% |
Conversion to open surgery rate | |||
---|---|---|---|
Author (year) | Ref. | Synthesized finding | Favours |
Shenoy et al. (2021) | [32] | Comparable results in conversion to open surgery rates were observed between RALS and CLS. | None |
Incisional hernia rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Shenoy et al. (2021) | [32] | Incisional hernia rate did not differ significantly between RALS and CLS. | None |
Intraoperative complication rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Shenoy et al. (2021) | [32] | No significant differences were observed between RALS and CLS. | None |
Postoperative complication rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Lin et al. (2023) | [38] | Based on ranking probabilities, the best surgical options for reducing postoperative complications are: three-port (61.3%) and four-port (21.8%) laparoscopy. | CLS |
Operative time | |||
Author (year) | Ref. | Synthesized finding | Favours |
Shenoy et al. (2021) | [32] | Operative time was longer in cholecystectomy performed by RALS compared to CLS. | CLS |
Lin et al. (2023) | [38] | The first ranking probabilities for reducing operation time showed that the three-port laparoscopic technique had the shortest operation time, followed by four-port. | CLS |
Length of hospital stay | |||
Author (year) | Ref. | Synthesized finding | Favours |
Shenoy et al. (2021) | [32] | The length of hospital stay between RALS and CLS was comparable for cholecystectomy. | None |
Lin et al. (2023) | [38] | The first ranking probabilities for reducing hospital stay (days) are: robotic (32.3%) followed by three-port (29.0%). | RALS |
Readmission rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Shenoy et al. (2021) | [32] | The readmission rate after RALS and CLS cholecystectomy was comparable. | None |
Blood loss | |||
---|---|---|---|
Author (year) | Ref. | Synthesized finding | Favours |
Cuk et al. (2023) | [45] | RALS reduced intraoperative blood loss compared to CLS. | RALS |
Conversion to open surgery rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Cuk et al. (2023) | [45] | No differences in conversion rates between RALS and CLS were observed. | None |
Petz et al. (2021) | [30] | RALS showed lower conversion rates compared to CLS. | RALS |
Waters et al. (2020) | [57] | Patients undergoing RALS have a lower conversion to open surgery rate compared to CLS. | RALS |
Incisional hernia rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Waters et al. (2020) | [57] | Patients undergoing RALS colectomy have a significantly lower incisional hernia rate compared to CLS colectomy. | RALS |
Postoperative complication rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Petz et al. (2021) | [30] | No differences in postoperative complication rates were found.. | None |
Operative time | |||
Author (year) | Ref. | Synthesized finding | Favours |
Petz et al. (2021) | [30] | In all the comparative studies included, the operative time of RALS was significantly longer than CLS. | CLS |
Waters et al. (2020) | [57] | RALS operative time was found to be significantly longer compared to LRH in thirteen studies. | CLS |
Length of hospital stay | |||
Author (year) | Ref. | Synthesized finding | Favours |
Cuk et al. (2023) | [45] | The RALS group had a shorter hospital stay compared to the CLS group. | RALS |
Waters et al. (2020) | [57] | Patients undergoing RALS experience a significantly shorter hospital stay compared to CLS. | RALS |
Wound infection rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Waters et al. (2020) | [57] | No significant differences in wound infection rates were observed between CLS and RALS among ten included studies. | None |
Blood loss | |||
---|---|---|---|
Author (year) | Ref. | Synthesized finding | Favours |
Alshowaikh et al. (2021) | [59] | The blood loss between CLS and RALS hysterectomy was comparable. | None |
Guo et al. (2023) | [64] | On a SUCRA ranking of five surgical approaches, the RALS approach scored best. The laparoscopic approach was ranked second. | RALS |
Hospitalization costs | |||
Author (year) | Ref. | Synthesized finding | Favours |
Alshowaikh et al. (2021) | [59] | The cost associated with RALS was higher than the costs of CLS hysterectomy. | CLS |
Postoperative complication rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Alshowaikh et al. (2021) | [59] | The overall complication rate was comparable between RALS and CLS hysterectomy. | None |
Prodromidou et al. (2020) | [60] | No differences in either major or overall postoperative complication rates were observed between RALS and CLS hysterectomy. | None |
Guo et al. (2023) | [64] | Among a SUCRA ranking of five surgical approaches, RALS was ranked higher than CLS regarding the overall complication rate. | RALS |
Operative time | |||
Author (year) | Ref. | Synthesized finding | Favours |
Alshowaikh et al. (2021) | [59] | The operative time between CLS and RALS hysterectomy was comparable. | None |
Prodromidou et al. (2020) | [60] | Neither the total operative time nor the operative time (pre-surgical procedures excluded) showed any differences between RALS and CLS. | None |
Guo et al. (2023) | [64] | The operative time, compared between five surgical approaches with a SUCRA ranking, is the shortest for open surgery. The second best is laparoscopic surgery. The operative time of RALS is ranked fourth. | CLS |
Length of hospital stay | |||
Author (year) | Ref. | Synthesized finding | Favours |
Alshowaikh et al. (2021) | [59] | No statistical differences were observed between RALS and CLS hysterectomy for the length of hospital stay. | None |
Guo et al. (2023) | [64] | Among a SUCRA ranking of five surgical approaches, the RALS proved to be the preferred approach for the shortest hospital stay. The laparoscopic approach was ranked second. | RALS |
Blood loss | |||
---|---|---|---|
Author (year) | Ref. | Synthesized finding | Favours |
Veccia et al. (2020) | [68] | Lower blood losses were observed in patients in the RALS group. | RALS |
Tang et al. (2020) | [28] | There was less blood loss in RALS partial nephrectomy compared to CLS. | RALS |
Intraoperative complication rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Zahid et al. (2022) | [67] | Radical nephrectomy with RALS was associated with fewer perioperative complications. | RALS |
Veccia et al. (2020) | [68] | RALS had the lowest rate of intraoperative complications. | RALS |
Tang et al. (2020) | [28] | RALS and CLS obtained similar results on the intraoperative complications rate after partial nephrectomy. | None |
Postoperative complication rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Tang et al. (2020) | [28] | (Major) postoperative complication rates after CLS or RALS partial nephrectomy were comparable. | None |
Operative time | |||
Author (year) | Ref. | Synthesized finding | Favours |
Zahid et al. (2022) | [67] | Radical nephrectomy with RALS was associated with longer operative time | CLS |
Veccia et al. (2020) | [68] | The operative time for RALS and CLS nephroureterectomy was comparable. | None |
Tang et al. (2020) | [28] | Comparable results in operative time were observed between RALS and CLS. | None |
Length of hospital stay | |||
Author (year) | Ref. | Synthesized finding | Favours |
Veccia et al. (2020) | [68] | The length of hospital stay was statistically significantly shorter for the RALS group compared to CLS. | RALS |
Tang et al. (2020) | [28] | The length of hospital stay was shorter after a partial nephrectomy performed with RALS compared to CLS. | RALS |
Blood loss | |||
---|---|---|---|
Author (year) | Ref. | Synthesized finding | Favours |
Zahid et al. (2022) | [67] | Less blood loss was observed during RALS as compared to other approaches. | RALS |
Kordan et al. (2020) | [27] | Blood loss was comparable between RALS and CLS, with slightly less blood loss in favour of RALS. | None |
Intraoperative complication rate | |||
Author (year) | Ref. | Synthesized finding | Favours |
Zahid et al. (2022) | [67] | One study reported similar intraoperative complications. | None |
Operative time | |||
Author (year) | Ref. | Synthesized finding | Favours |
Kordan et al. (2020) | [27] | Operative time was shorter for CLS simple prostatectomy procedures compared to RALS. | CLS |
Length of hospital stay | |||
Author (year) | Ref. | Synthesized finding | Favours |
Zahid et al. (2022) | [67] | RALS showed a shorter length of hospital stay compared to other conventional procedures. | RALS |
Kordan et al. (2020) | [27] | Length of hospital stay was comparable between RALS and CLS simple prostatectomy. | None |
No. | Author (Year) | Ref. | Reason for exclusion |
---|---|---|---|
1 | Alkatout et al. (2022) | [84] | This paper does not compare RALS and CLS. The paper evaluated the outcomes of different Versius systems. |
2 | Charalambides et al. (2022) | [85] | This paper does not compare RALS with CLS. |
3 | Toh et al. (2020) | [86] | Wrong study type. This review does not have a methodology, is not systematic and only reviews some outcomes of a few randomly selected papers. |
4 | Oweira et al. (2023) | [87] | Full-text was not available. |
5 | Zhu et al. (2021) | [58] | This paper does not compare RALS with CLS. The paper compared two different Da Vinci systems instead. |
6 | Leitoa et al. (2023) | [88] | The clinical outcomes of interest have not been reported in this paper. |
7 | Kampers et al. (2021) | [89] | The clinical outcomes of interest have not been reported in this paper. |
8 | Nitecki et al. (2020) | [90] | The clinical outcomes of interest have not been reported in this paper. |
9 | Marra et al. (2019) | [91] | Full-text was not available. |
10 | Behbehani et al. (2019) | [92] | The clinical outcomes of interest have not been reported in this paper. |
11 | Behbehani et al. (2020) | [93] | The clinical outcomes of interest have not been reported in this paper. |
12 | Kostakis et al. (2019) | [94] | The clinical outcomes of interest have not been reported in this paper. |
13 | Hinojosa-Gonzalez et al. (2023) | [95] | Full-text was not available. |
14 | Lin et al. (2021) | [96] | Full-text was not available. Publication was removed. |
15 | Zahid et al. (2023) | [97] | "This review is excluded as it is a duplicate of [67]. [67] was included. |
16 | Cacciamai et al. (2018) | [76] | Full-text was not available. |
17 | Ficarra et al. (2018) | [98] | The clinical outcomes of interest have not been reported in this paper. |
18 | Cao et al. (2019) | [84] | This paper does not compare RALS with CLS. Instead, RALS and CLS patients formed one experimental group, which was compared with an open prostatectomy control group. |
19 | Sridharan et al. (2018) | [99] | The clinical outcomes of interest have not been reported in this paper. |
20 | Moretti et al. (2022) | [70] | Wrong study type. This paper is a reverse systematic review that includes all primary sources of identified systematic reviews, which should not be included in an umbrella review. |
21 | Marra et al. (2019) | [100] | The clinical outcomes of interest have not been reported in this paper. |
Element | Text Terms | MeSH Terms | # | Search Query | Results |
---|---|---|---|---|---|
Colectomy | colectomy colon resection(s) colon surgery/surgeries colorectal resection(s) colorectal surgery/surgeries |
Colectomy | 1 | “colectom*”[Title/Abstract] OR “colon resection*”[Title/Abstract] OR ”colon surger*”[Title/Abstract] OR ”colorectal resection*” OR ”colorectal surger*”[Title/Abstract] OR colectomy[MeSH Terms] |
167.044 |
Laparoscopy | laparoscopy laparoscopies laparoscopic surgery/surgeries conventional laparoscopy conventional laparoscopic surgery/surgeries CLS |
Laparoscopy | 2 | “laparoscop*”[Title/Abstract[ OR laparoscopy[MeSH Terms] |
167.858 |
Robot-asssisted laparoscopy | robot-assisted laparoscopic surgery/surgeries RALS robot-assisted surgery/surgeries robotically assisted laparoscopic surgery/surgeries robot surgery/surgeries robotic surgery/surgeries advanced laparoscopic surgery/surgeries advanced laparoscopy |
Robotic Surgical Procedures | 3 | Robotic Surgical Procedures[MeSH Terms] OR “robot*”[Title/Abstract] OR ”robot-assisted”[Title/Abstract] |
67.816 |
Systematic Review or Meta-analysis | Systematic Review Systematically review Meta-Analysis Meta-Analytic Review |
4 | ”Systematic review”[Publication Type] OR ”Meta-analysis”[Publication Type] OR ”Systematic* Review”[Title/Abstract] OR ”Meta-Analy*”[Title/Abstract] |
- | |
Publication date | last 5 years: 01/01/2018 – 01/01/2023 | 5 | (”2018/01/01”[Date – Publication] : ”2023/01/01”[Date – Publication]) |
- | |
Language | English | 6 | ”English”[Language] | - | |
Final search conducted on 11 February 2023 | #1 AND #2 AND #3 AND #4 AND #5 AND #6 | 59 |
Element | # | Title | Results |
---|---|---|---|
Colectomy | 1 | TITLE-ABS(“colectom*” OR ”colon resection*” OR ”colon surger*” OR ”colorectal resection*” OR ”colorectal surger*”) |
170.759 |
Laparoscopy | 2 | TITLE-ABS (“laparoscop*”) | 29.086 |
Robot-assisted laparoscopy |
3 | TITLE-ABS (“robot* OR ”robot-assisted”) | 469.798 |
Systematic Review or Meta-analysis |
4 | TITLE-ABS ( ”Systematic* review” OR ”Meta-analy*” ) | - |
Search query | #1 AND #2 AND #3 AND #4 | 67 | |
Additional filters | |||
Publication date | 5 | last 5 years: 01/01/2018 – 01/01/2023 | - |
Document types (peer-reviewed only) | 6 | articles or reviews | - |
Subject area | 7 | Medicine | - |
Language | 8 | English | - |
Final search query | 29 |
Critical Flaws | Non-Critical Flaws |
---|---|
Protocol registered before commencement of the review (item 2) | Satisfying the components of PICO (population, intervention, comparison, and outcome) |
Adequacy of the literature search (item 4) | Clarification of the reasons for selection of the study designs for inclusion in the review. |
Justification for excluding individual studies (item 7) | Study selection is done in duplicate |
Risk of bias from individual studies being included in the review (item 9) | Data extraction is done in duplicate |
Appropriateness of meta-analytical methods (item 11) | Detailed description of the included studies |
Consideration of risk of bias when interpreting the results of the review (item 13) | Report on the sources of funding for the primary studies |
Assessment of presence and likely impact of publication bias (item 15) | Assessment of the potential impact of risk of bias on the results of the evidence synthesis Satisfactory explanation for any heterogeneity |
Report of any potential sources of conflict of interest |
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