Short-term efficacy of da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer: a Meta analysis / 中华消化外科杂志

ABSTRACT

Objective To compare the short-term efficacy between da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer.Methods Database including PubMed,EMBASE,the Cochrane Library,Medline,the China National Knowledge Infrastructure (CNKI),Wanfang Database,VIP and China Biomedicine were searched with the key words of gastric cancer,gastrectomy,da Vinci surgical system,laparoscopic,laparoscopy,胃癌,胃切除术,达芬奇机器人手术系统and腹腔镜.Literatures published between May 2002 and March 2014 were retrieved.Related controlled trials containing the clinical efficacy of da Vinci robotic and laparoscopic radical gastrectomy for gastric cancer were enrolled in the study,and then the literatures were screened and the data were extracted by 2 independent reviewers.The quality of the literatures was assessed,and the data were analyzed using the RevMan 5.2 software.Patients receiving da Vinci robotic surgery and laparoscopic surgery were allocated into the robotic group and laparoscopy group,respectively.The count data were analyzed using the relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using weighted mean difference (WMD) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Results Eleven literatures including 3 698 cases were enrolled in the study.There were 953 patients in the robotic group and 2 745 patients in the laparoscopic group.There were significant differences in the operation time,volume of intraoperative blood loss,time of postoperative flatus,time of first oral intake and duration of postoperative hospital stay between the 2 groups (WMD =51.23,-36.96,-0.24,-0.26,-1.11,95％ CI28.01-74.46,-61.28--12.65,-0.42--0.06,-0.39--0.14,-1.92--0.29,P ＜ 0.05).There was no significant difference in the number of lymph nodes resected,the distance to proximal and distal resection margin and overall incidence of postoperative complications (WMD =1.63,0.21,0.06,RR =1.11,95％ CI-0.49-3.76,-0.65-1.06,-0.13-0.25,0.90-1.37,P ＞ 0.05).Conclusion Da Vinci robotic radical gastrectomy for gastric cancer is safe and feasible,with the advantages of minimal invasion and rapid postoperative recovery.