Robotic versus Open Gastrectomy for Gastric Cancer: A Meta-Analysis |
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Authors: | Guixiang Liao Jiarong Chen Chen Ren Rong Li Shasha Du Guozhu Xie Haijun Deng Kaijun Yang Yawei Yuan |
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Institution: | 1. Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China.; 2. Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China.; 3. Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China.; University Hospital Heidelberg, Germany, |
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Abstract: | AimTo evaluate the safety and efficacy of robotic gastrectomy versus open gastrectomy for gastric cancer.MethodsA comprehensive search of PubMed, EMBASE, Cochrane Library, and Web of Knowledge was performed. Systematic review was carried out to identify studies comparing robotic gastrectomy and open gastrectomy in gastric cancer. Intraoperative and postoperative outcomes were also analyzed to evaluate the safety and efficacy of the surgery. A fixed effects model or a random effects model was utilized according to the heterogeneity.ResultsFour studies involving 5780 patients with 520 (9.00%) cases of robotic gastrectomy and 5260 (91.00%) cases of open gastrectomy were included in this meta-analysis. Compared to open gastrectomy, robotic gastrectomy has a significantly longer operation time (weighted mean differences (WMD) =92.37, 95% confidence interval (CI): 55.63 to 129.12, P<0.00001), lower blood loss (WMD: -126.08, 95% CI: -189.02 to -63.13, P<0.0001), and shorter hospital stay (WMD = -2.87; 95% CI: -4.17 to -1.56; P<0.0001). No statistical difference was noted based on the rate of overall postoperative complication, wound infection, bleeding, number of harvested lymph nodes, anastomotic leakage and postoperative mortality rate.ConclusionsThe results of this meta-analysis suggest that robotic gastrectomy is a better alternative technique to open gastrectomy for gastric cancer. However, more prospective, well-designed, multicenter, randomized controlled trials are necessary to further evaluate the safety and efficacy as well as the long-term outcome. |
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