Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis.
10.5230/jgc.2013.13.3.136
- Author:
Alessandra MARANO
1
;
Yoon Young CHOI
;
Woo Jin HYUNG
;
Yoo Min KIM
;
Jieun KIM
;
Sung Hoon NOH
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. wjhyung@yuhs.ac
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
Robotics;
Laparoscopy;
Gastrectomy;
Stomach neoplasms
- MeSH:
Gastrectomy;
Humans;
Laparoscopy;
Length of Stay;
Lymph Node Excision;
Lymph Nodes;
Operative Time;
Robotics;
Stomach Neoplasms
- From:Journal of Gastric Cancer
2013;13(3):136-148
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To define the role of robotic gastrectomy for the treatment of gastric cancer, the present systematic review with meta-analysis was performed. MATERIALS AND METHODS: A comprehensive search up to July 2012 was conducted on PubMed, EMBASE, and the Cochrane Library. All eligible studies comparing robotic gastrectomy versus laparoscopic gastrectomy or open gastrectomy were included. RESULTS: Included in our meta-analysis were seven studies of 1,967 patients that compared robotic (n=404) with open (n=718) or laparoscopic (n=845) gastrectomy. In the complete analysis, a shorter hospital stay was noted with robotic gastrectomy than with open gastrectomy (weighted mean difference: -2.92, 95% confidence interval: -4.94 to -0.89, P=0.005). Additionally, there was a significant reduction in intraoperative blood loss with robotic gastrectomy compared with laparoscopic gastrectomy (weighted mean difference: -35.53, 95% confidence interval: -66.98 to -4.09, P=0.03). These advantages were at the price of a significantly prolonged operative time for both robotic gastrectomy versus laparoscopic gastrectomy (weighted mean difference: 63.70, 95% confidence interval: 44.22 to 83.17, P<0.00001) and robotic gastrectomy versus open gastrectomy (weighted mean difference: 95.83, 95% confidence interval: 54.48 to 137.18, P<0.00001). Analysis of the number of lymph nodes retrieved and overall complication rates revealed that these outcomes did not differ significantly between the groups. CONCLUSIONS: Robotic gastrectomy for gastric cancer reduces intraoperative blood loss and the postoperative hospital length of stay compared with laparoscopic gastrectomy and open gastrectomy at a cost of a longer operating time. Robotic gastrectomy also provides an oncologically adequate lymphadenectomy. Additional high-quality prospective studies are recommended to better evaluate both short and long-term outcomes.
