Meta-analysis of short-term outcomes of robotic versus conventional laparoscopic distal pancreatectomy / 国际外科学杂志

ABSTRACT

Objective:To compare the short-term clinical outcomes of robotic distal pancreatectomy(RDP) with laparoscopic distal pancreatectomy(LDP).Methods:PubMed, Embase, Cochrane library, Wanfang data, CNKI were searched systematically.Studies that compared short-term clinic outcomes between RDP and LDP groups were included. Observation indicators include operation time, intraoperative blood transfusion rate, spleen preserving rate, spleen vessels preserving rate, conversion rate to open surgery, complication rate, severe complication rate, pancreatic fistula rate, severe pancreatic fistula rate, length of hospital stay, etc. The Meta-analysis was performed by using RevMan5.3.Results:Eleven non-randomized controlled trials with 791 patients meet the inclusion criteria.This Meta-analysis shows compared with LDP group, RDP group was associated with higher spleen preserving rate ( OR=2.32, 95% CI 1.07-5.04, P=0.03), higher splenic vessels preserving rate ( OR=3.07, 95% CI 1.10-8.57, P=0.03), lower conversion rate to open surgery ( OR=0.58, 95% CI 0.35-0.97, P=0.04), shorter hospital stay ( MD=-2.42, 95% CI -4.30 --0.55, P=0.01), longer operative time ( MD=27.11, 95% CI 9.06-45.16, P<0.01). There was no significant difference in overall complications, severe complications, pancreatic fistula, severe pancreatic fistula, and transfusion rate between the two groups. Conclusions:RDP showed a slight advantage in short-term outcomes, and it is worthy of applying in large medical center. Further studies on the long-term outcomes of these surgical techniques are required.