The COMPARE study aimed to systematically assess 30-day outcomes of da Vinci robotic-assisted (dV-RAS) versus laparoscopic or video-assisted thoracoscopic (lap/VATS) or open oncologic surgery.

This systematic review and meta-analysis included 230 studies: 34 randomized controlled trials, 74 prospective studies, and 122 database studies. Seven oncologic procedures were examined, including hysterectomy for cervical and endometrial cancer, partial nephrectomy, prostatectomy, right colectomy, low anterior resection/total mesorectal excision (LAR/TME), and lobectomy. The analysis encompassed approximately 1.2 million RAS cases, 1.1 million laparoscopic cases, and 1.6 million open procedures.

Compared to laparoscopic surgery, RAS was associated with longer operative times but demonstrated shorter hospital stays and fewer conversions to open surgery, blood transfusions, postoperative complications, readmissions, and deaths. When compared to open surgery, RAS also had longer operative times but showed significantly improved outcomes, including reduced transfusion rates, fewer complications, readmissions, reoperations, and lower mortality.