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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Gastric Cancer Association
2013
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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. |
format | Online Article Text |
id | pubmed-3804672 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | The Korean Gastric Cancer Association |
record_format | MEDLINE/PubMed |
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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