Efficacy of Da Vinci robot-assisted minimally invasive esophagectomy versus video-assisted minimally invasive esophagectomy: A systematic review and meta-analysis
- VernacularTitle:达芬奇机器人辅助与胸腹腔镜辅助微创食管癌切除术临床效果的系统评价与 Meta 分析
- Author:
Gang LI
1
,
2
;
Jiani ZHANG
1
,
3
;
Xu SHEN
4
;
Guha ALAI
1
,
5
;
Zhijie XU
1
,
5
;
Tieniu SONG
1
,
5
;
Yunke ZHU
4
;
Yidan LIN
4
Author Information
1. 1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
2. 2. Public Health Clinical Center of Chengdu, Chengdu, 610011, P. R. China
3. 3. West China School of Nursing, Sichuan University, Chengdu, 610011, P. R. China
4. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
5. 4. West China School of Medicine, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Da Vinci robot-assisted system;
thoracoscopic surgery;
minimally invasive esophagectomy;
esophageal carcinoma;
systematic review/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(09):1181-1188
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the surgical efficacy of Da Vinci robot-assisted minimally invasive esophagectomy (RAMIE) and video-assisted minimally invasive esophagectomy (VAMIE) on esophageal cancer. Methods Online databases including PubMed, the Cochrane Library, Medline, EMbase and CNKI from inception to 31, December 2019 were searched by two researchers independently to collect the literature comparing the clinical efficacy of RAMIE and VAMIE on esophageal cancer. Newcastle-Ottawa Scale was used to assess quality of the literature. The meta-analysis was performed by RevMan 5.3. Results A total of 14 studies with 1 160 patients were enrolled in the final study, and 12 studies were of high quality. RAMIE did not significantly prolong total operative time (P=0.20). No statistical difference was observed in the thoracic surgical time through the McKeown surgical approach (MD=3.35, 95%CI –3.93 to 10.62, P=0.37) or in surgical blood loss between RAMIE and VAMIE (MD=–9.48, 95%CI –27.91 to 8.95, P=0.31). While the RAMIE could dissect more lymph nodes in total and more lymph nodes along the left recurrent laryngeal recurrent nerve (MD=2.24, 95%CI 1.09 to 3.39, P=0.000 1; MD=0.89, 95%CI 0.13 to 1.65, P=0.02) and had a lower incidence of vocal cord paralysis (RR=0.70, 95%CI 0.53 to 0.92, P=0.009). Conclusion There is no statistical difference observed between RAMIE and VAMIE in surgical time and blood loss. RAMIE can harvest more lymph nodes than VAMIE, especially left laryngeal nerve lymph nodes. RAMIE shows a better performance in reducing the left laryngeal nerve injury and a lower rate of vocal cord paralysis compared with VAMIE.
