Robotic versus laparoscopic distal pancreatectomy: an up-to-date meta-analysis

BMC Surgery

Research Article

Matteo Olivieri¹  Claudio Belluco¹  Giulio Bertola¹  Stefania Basso¹  Andrea Lauretta¹  Bruno Breda¹  Marco Forlin¹  Gian Piero Guerrini²  Fabrizio Di Benedetto³ 

[1] Department of Surgical Oncology. Surgical oncology Unit, National Cancer institute-Centro di Riferimento Oncologico IRCCS, Aviano (PN), Italy;Department of Surgical Oncology. Surgical oncology Unit, National Cancer institute-Centro di Riferimento Oncologico IRCCS, Aviano (PN), Italy;Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy;Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy;

关键词: Pancreatic cancer;    Distal pancreatectomy;    Left pancreatectomy;    Pancreatic resection;    Robotic surgery;    Laparoscopic surgery;    Review;    Meta-analysis;   

DOI  :  10.1186/s12893-017-0301-3

 received in 2017-06-04, accepted in 2017-11-01,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundLaparoscopic distal pancreatectomy (LDP) reduces postoperative morbidity, hospital stay and recovery as compared with open distal pancreatectomy. Many authors believe that robotic surgery can overcome the difficulties and technical limits of LDP thanks to improved surgical manipulation and better visualization. Few studies in the literature have compared the two methods in terms of surgical and oncological outcome. The aim of this study was to compare the results of robotic (RDP) and laparoscopic distal pancreatectomy.MethodsA systematic review and meta-analysis was conducted of control studies published up to December 2016 comparing LDP and RDP. Two Reviewers independently assessed the eligibility and quality of the studies. The meta-analysis was conducted using either the fixed-effect or the random-effect model.ResultsTen studies describing 813 patients met the inclusion criteria. This meta-analysis shows that the RDP group had a significantly higher rate of spleen preservation [OR 2.89 (95% confidence interval 1.78-4.71, p < 0.0001], a lower rate of conversion to open OR 0.33 (95% CI 0.12-0.92), p = 0.003] and a shorter hospital stay [MD -0.74; (95% CI -1.34 -0.15), p = 0.01] but a higher cost than the LDP group, while other surgical outcomes did not differ between the two groups.ConclusionThis meta-analysis suggests that the RDP procedure is safe and comparable in terms of surgical results to LDP. However, even if the RDP has a higher cost compared to LDP, it increases the rate of spleen preservation, reduces the risk of conversion to open surgery and is associated to shorter length of hospital stay.

【 授权许可】

CC BY   
© The Author(s). 2017