The urinary and sexual outcomes of robot-assisted versus laparoscopic rectal cancer surgery: a systematic review and meta-analysis

To compare the urinary and sexual outcomes between robot-assisted rectal cancer (RC) surgery (RRCS) and laparoscopic RC surgery (LRCS) using a meta-analysis, searches were conducted of the Embase, PubMed, Cochrane Library, CNKI, and Wanfang databases. The International Prostate Symptom Score (IPSS) was the primary outcome. Eleven studies (790 patients with RRCS and 888 with LRCS) were included. The IPSS scores were significantly lower for RRCS than LRCS from baseline to 3 months (weighted mean difference [WMD] =  − 1.21, 95% confidence interval [CI]: − 1.8,-0.62, I² = 89.9%), to 6 months (WMD =  − 1.13, 95% CI: − 1.74, − 0.52, I² = 93.3%), and to 12 months (WMD =  − 0.93, 95% CI: − 1.59, − 0.26, I² = 93.8%). The International Index of Erectile Function (IIEF) scores were significantly higher for RRCS than LRCS from baseline to 3 months (WMD = 3.36, 95% CI: 1.28, 5.44, I² = 92.7%). The female sexual function index (FSFI) scores were significantly higher for RRCS than LRCS from baseline to 3 months (WMD = 1.31, 95% CI: 0.87, 1.76, I² = 0), to 6 months (WMD = 2.36, 95% CI: 1.93, 2.79, I² = 24.3%), and to 12 months (WMD = 1.67, 95% CI: 0.41, 2.93, I² = 90.9%). RRCS also achieved a better recovery of the urological and sexual function than LRCS for patients with RC. Larger-scale prospective randomized control trials are needed to verify these results.