To conduct a meta-analysis of the therapeutic effects of robot-assisted complete mesocolic excision (R-CME) for right-sided colon cancer.

A search was conducted in databases including CNKI, Wanfang, PubMed, NCBI up to October 10, 2023, for controlled studies comparing R-CME and laparoscopic complete mesocolic excision (L-CME) in the treatment of right-sided colon cancer. Two researchers independently extracted relevant research data and conducted literature reviews. Clinical data were collected and analyzed using RevMan 5.3 software, and positive results were further subjected to trial sequential analysis using TSA 0.9 Beta version.

Eight retrospective analysis studies were included, involving a total of 1 106 patients, with 532 in the R-CME group and 574 in the L-CME group. The R-CME group had a higher number of lymph nodes harvested during surgery (MD=3.21, 95% CI: 0.62, 5.80; P=0.02); less intraoperative blood loss (MD=-13.58, 95% CI: -19.72, -7.44; P<0.000 1); and shorter postoperative hospital stay (MD=-0.55, 95% CI: -1.02, -0.07; P=0.02). No significant differences were observed between the two groups in terms of specimen length (MD=0.32, 95% CI: -0.20, 0.85; P=0.23), time to first oral intake (MD=0.12, 95% CI: -0.10, 0.33; P=0.28), and time to first flatus (MD=0.06, 95% CI: -0.36, 0.47; P=0.79). There were no significant differences between the two groups regarding postoperative complications, including anastomotic leakage (OR=0.35, 95% CI: 0.11, 1.10; P=0.07), pulmonary infection (OR=1.13, 95% CI: 0.37, 3.52; P=0.83), intestinal obstruction (OR=0.67, 95% CI: 0.28, 1.58; P=0.36), and incision infection (OR=1.25, 95% CI: 0.58, 2.67; P=0.57). The R-CME group did not show advantages in surgical time (MD=35.04, 95% CI: 14.40, 55.67; P=0.000 9). Trial sequential analysis further confirmed the advantages of R-CME in controlling intraoperative blood loss and lymph nodes dissection. The superiority in terms of hospital stay still needed further discussion, and currently there was no advantage for R-CME in terms of operative time.

R-CME provides better therapeutic outcomes for right-sided colon cancer, offering safer surgical environment, effectively avoiding transfusion-related risks, enhancing the accuracy of tumor pathology assessment, and aiding in the formulation of subsequent treatment plans. R-CME is worthy of clinical promotion.