Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis
Summary: To compare the clinical efficacy and safety of robotic-assisted liver resection (RLR) and laparoscopic liver resection (LLR) by the means of meta-analytical techniques. We searched PubMed, Cochrane library, Embase and Web of Science databases, collecting randomized or non-randomized studies...
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doaj-03d014811edc49408bdb990524d50d9a2020-11-25T01:18:29ZengElsevierAsian Journal of Surgery1015-95842019-01-014211931Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysisRuoyu Guan0Yongjun Chen1Kui Yang2Di Ma3Xiaoyong Gong4Baiyong Shen5Chenghong Peng6Department of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaCorresponding author. Department of Hepatobiliary surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China. Fax: +86 021 54660106.; Department of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaSummary: To compare the clinical efficacy and safety of robotic-assisted liver resection (RLR) and laparoscopic liver resection (LLR) by the means of meta-analytical techniques. We searched PubMed, Cochrane library, Embase and Web of Science databases, collecting randomized or non-randomized studies about robotic-assisted and laparoscopic liver resections. The searching cutoff date was 2017/6/30, all the data obtained were statistically analyzed using RevMan5.3 software recommended by Cochrane Collaboration. A total of thirteen articles, involving 938 patients were enrolled in meta-analysis. Among them, 435 cases underwent RLR, and 503 cases underwent LLR. Compared with LLR, the RLR had longer operative time [MD=65.49, 95%CI (42.00, 88.98) P<0.00001=more intraoperative blood loss [MD=69.88, 95%CI (27.11, 112.65) P=0.001] and a higher cost [MD=4.24, 95%CI (3.08, 5.39) P<0.00001=. There were no significant differences between the two groups in transfusion rate, complication rate, conversion rate, the R1 resection rate and hospital stay. In the subgroup analysis of surgery after 2010, a lower conversion rate was observed in RLR, other clinical outcomes are comparable between RLR and LLR. In the subgroup analysis of minor hepatectomy, RLR is still associated with longer operative time, but there is no difference in other outcomes. In the subgroup analysis of left hemihepatectomy or left lateral hepatectomy, RLR is associated with more blood loss. Although RLR associated with Longer operative time and more intraoperative blood loss, it displays the same safety and effectiveness as LLR for hepatectomies. And the high cost is still a major hindrance for the widely application of robotic surgery. Keywords: Robotic-assisted, Laparoscopic, Liver resection, Meta-analysishttp://www.sciencedirect.com/science/article/pii/S1015958417306784 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ruoyu Guan Yongjun Chen Kui Yang Di Ma Xiaoyong Gong Baiyong Shen Chenghong Peng |
spellingShingle |
Ruoyu Guan Yongjun Chen Kui Yang Di Ma Xiaoyong Gong Baiyong Shen Chenghong Peng Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis Asian Journal of Surgery |
author_facet |
Ruoyu Guan Yongjun Chen Kui Yang Di Ma Xiaoyong Gong Baiyong Shen Chenghong Peng |
author_sort |
Ruoyu Guan |
title |
Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis |
title_short |
Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis |
title_full |
Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis |
title_fullStr |
Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis |
title_full_unstemmed |
Clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis |
title_sort |
clinical efficacy of robot-assisted versus laparoscopic liver resection: a meta analysis |
publisher |
Elsevier |
series |
Asian Journal of Surgery |
issn |
1015-9584 |
publishDate |
2019-01-01 |
description |
Summary: To compare the clinical efficacy and safety of robotic-assisted liver resection (RLR) and laparoscopic liver resection (LLR) by the means of meta-analytical techniques. We searched PubMed, Cochrane library, Embase and Web of Science databases, collecting randomized or non-randomized studies about robotic-assisted and laparoscopic liver resections. The searching cutoff date was 2017/6/30, all the data obtained were statistically analyzed using RevMan5.3 software recommended by Cochrane Collaboration. A total of thirteen articles, involving 938 patients were enrolled in meta-analysis. Among them, 435 cases underwent RLR, and 503 cases underwent LLR. Compared with LLR, the RLR had longer operative time [MD=65.49, 95%CI (42.00, 88.98) P<0.00001=more intraoperative blood loss [MD=69.88, 95%CI (27.11, 112.65) P=0.001] and a higher cost [MD=4.24, 95%CI (3.08, 5.39) P<0.00001=. There were no significant differences between the two groups in transfusion rate, complication rate, conversion rate, the R1 resection rate and hospital stay. In the subgroup analysis of surgery after 2010, a lower conversion rate was observed in RLR, other clinical outcomes are comparable between RLR and LLR. In the subgroup analysis of minor hepatectomy, RLR is still associated with longer operative time, but there is no difference in other outcomes. In the subgroup analysis of left hemihepatectomy or left lateral hepatectomy, RLR is associated with more blood loss. Although RLR associated with Longer operative time and more intraoperative blood loss, it displays the same safety and effectiveness as LLR for hepatectomies. And the high cost is still a major hindrance for the widely application of robotic surgery. Keywords: Robotic-assisted, Laparoscopic, Liver resection, Meta-analysis |
url |
http://www.sciencedirect.com/science/article/pii/S1015958417306784 |
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