Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis

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 compar...

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Autores principales: Marano, Alessandra, Choi, Yoon Young, Hyung, Woo Jin, Kim, Yoo Min, Kim, Jieun, Noh, Sung Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Gastric Cancer Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804672/
https://www.ncbi.nlm.nih.gov/pubmed/24156033
http://dx.doi.org/10.5230/jgc.2013.13.3.136
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author Marano, Alessandra
Choi, Yoon Young
Hyung, Woo Jin
Kim, Yoo Min
Kim, Jieun
Noh, Sung Hoon
author_facet Marano, Alessandra
Choi, Yoon Young
Hyung, Woo Jin
Kim, Yoo Min
Kim, Jieun
Noh, Sung Hoon
author_sort Marano, Alessandra
collection PubMed
description 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.
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spelling pubmed-38046722013-10-23 Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis Marano, Alessandra Choi, Yoon Young Hyung, Woo Jin Kim, Yoo Min Kim, Jieun Noh, Sung Hoon J Gastric Cancer Original Article 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. The Korean Gastric Cancer Association 2013-09 2013-09-30 /pmc/articles/PMC3804672/ /pubmed/24156033 http://dx.doi.org/10.5230/jgc.2013.13.3.136 Text en Copyright © 2013 by The Korean Gastric Cancer Association http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Marano, Alessandra
Choi, Yoon Young
Hyung, Woo Jin
Kim, Yoo Min
Kim, Jieun
Noh, Sung Hoon
Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis
title Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis
title_full Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis
title_fullStr Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis
title_full_unstemmed Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis
title_short Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis
title_sort robotic versus laparoscopic versus open gastrectomy: a meta-analysis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804672/
https://www.ncbi.nlm.nih.gov/pubmed/24156033
http://dx.doi.org/10.5230/jgc.2013.13.3.136
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