Comparison of Short-Term Outcomes of Intracorporeal Anastomosis in Robot-Assisted colon Resection and Laparoscopic colon Resection: A Single-Center Study and Systematic Review and meta-Analysis.

BACKGROUND: This study evaluates short-term outcomes of robot-assisted (Rt) and laparoscopic (Lap) intracorporeal anastomosis (IA) in colon resection using an exploratory single-center retrospective cohort and a systematic review and meta-analysis conducted in accordance with PRISMA guidelines. METHODS: Patients with colon cancer who underwent laparoscopic or robotic surgery at our institution from 2015 to 2024 were retrospectively enrolled. Additionally, a meta-analysis was conducted using PubMed, Web of Science, Scopus, and the Cochrane Library to identify studies comparing Rt-IA and Lap-IA. Short-term outcomes were statistically compared between the two groups. RESULTS: A total of 77 patients were included (Rt-IA 26, Lap-IA 51). Intraoperative blood loss was significantly lower in the Rt-IA group (median, 5 mL vs. 10 mL; p = 0.001). No statistically significant differences were detected in major postoperative complications or most recovery-related outcomes. For the meta-analysis, 11 studies (1 prospective and 10 retrospective) met the inclusion criteria. After adding our institutional data, the pooled analysis showed that operative time was significantly longer in the Rt-IA group (MD, 54.02 min; 95% CI, 34.18-73.86; I2 = 95.4%), whereas the Rt-IA group demonstrated significantly less blood loss (MD, -14.33 mL; 95% CI: -27.04 to -1.63; I2 = 19.3%). CONCLUSIONS: The results of our institutional analysis together with meta-analysis suggest that Rt-IA may be associated with longer operative time but slightly lower blood loss than Lap-IA. These findings suggest that Rt-IA may be a feasible alternative to Lap-IA; however, the results should be interpreted with caution given the limitations of the available evidence.