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01.06.2013 | Healthcare Policy and Outcomes | Ausgabe 6/2013

Annals of Surgical Oncology 6/2013

Robotic versus Open Pancreatectomy: A Systematic Review and Meta-analysis

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 6/2013
Autoren:
MD Jie Zhang, MD Wen-Ming Wu, MD Lei You, MD Yu-Pei Zhao

Abstract

Background

Robotic surgery is gaining momentum with advantages for minimally invasive management of pancreatic diseases. The objective of this meta-analysis is to compare the clinical and oncologic safety and efficacy of robotic versus open pancreatectomy.

Methods

A systematic review of the literature was performed to identify studies comparing robotic pancreatectomy and open pancreatectomy. Postoperative outcomes, intraoperative outcomes, and oncologic safety were evaluated. Meta-analysis was performed using a random-effect model.

Results

Seven studies matched the selection criteria, including 137 (40 %) cases of robotic pancreatectomy and 203 (60 %) cases of open pancreatectomy. None of the included studies were randomized. Overall complication rate was significantly lower in robotic group [risk difference (RD) = −0.12, 95 % confidence interval (CI) −0.22 to −0.01, P = 0.03], as well as reoperation rate (RD = −0.12; CI −0.2 to −0.03, P = 0.006) and margin positivity (RD = −0.18; 95 % CI −0.3 to −0.06, P = 0.003). There was no significant difference in postoperative pancreatic fistula (POPF) incidence and mortality. The median (range) conversion rate was 10 % (0–12 %).

Conclusions

The results of this meta-analysis suggest that robotic pancreatectomy is as safe and efficient as, if not superior to, open surgery for patients with benign or malignant pancreatic diseases. However, the evidence is limited and more randomized controlled trials are needed to further clearly define this role.

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