Effects of Robotic Versus Laparoscopic Surgery for Rectal Cancer on Male Urinary Function: a Meta-analysis

The purpose of this study was to evaluate whether robotic surgery is superior to laparoscopic surgery for protecting urinary function in male patients with rectal cancer. We systematically searched PubMed, Web of Science Core Collection, Cochrane Library, and Embase databases for relevant articles in April 2020. All articles about the differences between robotic and laparoscopic surgeries for rectal cancer were identified. The patients' urinary function was assessed using the International Prostate Symptom Score (IPSS). After searching, eight studies with 955 male patients were included. Four hundred sixty-six male patients were included in the robotic group, and 489 male patients were included in the laparoscopic group. Statistical analysis of the IPSS scores indicated that robotic surgery provided better recovery of male urinary function than laparoscopic surgery at 3 and 12 months post-operatively (mean difference(MD), - 1.26; 95% CI, - 2.24 to - 0.07;p = 0.04; and MD, - 1.02; 95% CI, - 1.79 to - 0.25;p = 0.009); there was no significant difference between the two groups at 6 months post-operatively (MD, - 0.76; 95% CI, - 1.73 to 0.21;p = 0.12). Therefore, we concluded that robotic rectal cancer surgery is more effective than laparoscopic rectal cancer surgery in protecting male urinary function.