Background To evaluate outcomes of robotic versus conventional laparoscopic colorectal resections in patients with inflammatory bowel disease (IBD). Methods Comparative studies of robotic versus laparoscopic colorectal resections in patients with IBD were included. Primary outcome was total post-operative complication rate. Secondary outcomes included operative time, conversion to open surgery, anastomotic leaks, intra-abdominal abscess formation, ileus occurrence, surgical site infection, re-operation, re-admission rate, length of hospital stay, and 30-day mortality. Combined overall effect sizes were calculated using random-effects model and the Newcastle-Ottawa Scale was used to assess risk of bias. Results Eleven non-randomised studies (n=5,566 patients) divided between those undergoing robotic (n=365) and conventional laparoscopic (n=5,201) surgery were included. Robotic platforms were associated with a significantly lower overall post-operative complication rate compared with laparoscopic surgery (P=0.03). Laparoscopic surgery was associated with a significantly shorter operative time (P=0.00001). No difference was found in conversion rates to open surgery (P=0.15), anastomotic leaks (P=0.84), abscess formation (P=0.21), paralytic ileus (P=0.06), surgical site infections (P=0.78), re-operation (P=0.26), re-admission rate (P=0.48), and 30-day mortality (P=1.00) between the groups. Length of hospital stay was shorter following a robotic sub-total colectomy compared with conventional laparoscopy (P=0.03). Conclusion Outcomes in the surgical management of IBD are comparable between traditional laparoscopic techniques and robotic-assisted minimally invasive surgery demonstrating the safety and feasibility of robotic platforms. Larger studies investigating the use of robotic technology in Crohn’s disease and ulcerative colitis separately may be of benefit with specific focus on important IBD-related metrics.

中文翻译：

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炎症性肠病的微创手术：机器人与腹腔镜手术技术的系统回顾和荟萃分析

背景 评估机器人与传统腹腔镜结直肠切除术对炎症性肠病 (IBD) 患者的疗效。方法 纳入了 IBD 患者机器人与腹腔镜结直肠切除术的比较研究。主要结局是术后总并发症发生率。次要结局包括手术时间、中转开放手术、吻合口瘘、腹内脓肿形成、肠梗阻发生、手术部位感染、再次手术、再入院率、住院时间和30天死亡率。使用随机效应模型计算综合总体效应大小，并使用纽卡斯尔-渥太华量表评估偏倚风险。结果 纳入了 11 项非随机研究（n=5,566 名患者），分为接受机器人手术（n=365）和传统腹腔镜手术（n=5,201）的患者。与腹腔镜手术相比，机器人平台的总体术后并发症发生率显着降低（P=0.03）。腹腔镜手术的手术时间显着缩短（P=0.00001）。开放手术中转率（P=0.15）、吻合口瘘（P=0.84）、脓肿形成（P=0.21）、麻痹性肠梗阻（P=0.06）、手术部位感染（P=0.78）、复发率没有差异。 -各组之间的手术（P=0.26）、再入院率（P=0.48）和30天死亡率（P=1.00）。与传统腹腔镜手术相比，机器人结肠次全切除术后的住院时间较短（P=0.03）。结论 传统腹腔镜技术与机器人辅助微创手术治疗 IBD 的效果相当，证明了机器人平台的安全性和可行性。分别研究机器人技术在克罗恩病和溃疡性结肠炎中的应用的更大型研究可能会有所裨益，特别关注重要的 IBD 相关指标。