Robotic versus laparoscopic Gastrectomy for gastric cancer: a systematic review and updated meta-analysis

BMC Surgery

Research Article

Xian-fa Wang¹  Yu Pan¹  Ke Chen¹  Xiu-jun Cai¹  Bin Zhang¹  Hendi Maher² 

[1] Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang Province, China;School of Medicine, Zhejiang University, 866 Yuhangtang Road, 310058, Hangzhou, Zhejiang Province, China;

关键词: Laparoscopy;    Robot;    Gastrectomy;    Stomach neoplasms;    Morbidity;    Meta-analysis;   

DOI  :  10.1186/s12893-017-0290-2

 received in 2017-06-11, accepted in 2017-08-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAdvanced minimally invasive techniques including robotic surgery are being employed with increasing frequency around the world, primarily in order to improve the surgical outcomes of laparoscopic gastrectomy (LG). We conducted a systematic review and meta-analysis to evaluate the feasibility, safety and efficacy of robotic gastrectomy (RG).MethodsStudies, which compared surgical outcomes between LG and RG, were retrieved from medical databases before May 2017. Outcomes of interest were estimated as weighted mean difference (WMD) or risk ratio (RR) using the random-effects model. The software Review Manage version 5.1 was used for all calculations.ResultsNineteen comparative studies with 5953 patients were included in this analysis. Compared with LG, RG was associated with longer operation time (WMD = −49.05 min; 95% CI: -58.18 ~ −39.91, P < 0.01), less intraoperative blood loss (WMD = 24.38 ml; 95% CI: 12.32 ~ 36.43, P < 0.01), earlier time to oral intake (WMD = 0.23 days; 95% CI: 0.13 ~ 0.34, P < 0.01), and a higher expense (WMD = −3944.8 USD; 95% CI: -4943.5 ~ −2946.2, P < 0.01). There was no significant difference between RG and LG regarding time to flatus, hospitalization, morbidity, mortality, harvested lymph nodes, and cancer recurrence.ConclusionsRG can be performed as safely as LG. However, it will take more effort to decrease operation time and expense.

【 授权许可】

CC BY   
© The Author(s). 2017