1. Safety and effectiveness of minimally invasive central pancreatectomy versus open central pancreatectomy: a systematic review and meta-analysis.
- Author
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Xia, Ning, Li, Jiao, Wang, Qiang, Huang, Xing, Wang, Zihe, Wang, Li, Tian, Bole, and Xiong, Junjie
- Subjects
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MEDICAL information storage & retrieval systems , *SURGICAL robots , *PATIENT safety , *RESEARCH funding , *PANCREATIC fistula , *LAPAROSCOPIC surgery , *MINIMALLY invasive procedures , *TREATMENT effectiveness , *META-analysis , *SURGICAL therapeutics , *SURGICAL blood loss , *DESCRIPTIVE statistics , *SYSTEMATIC reviews , *MEDLINE , *ODDS ratio , *SURGICAL complications , *PANCREATECTOMY , *MEDICAL databases , *ONLINE information services , *CONFIDENCE intervals , *LENGTH of stay in hospitals , *BLOOD transfusion , *DATA analysis software , *PERIOPERATIVE care , *EVALUATION - Abstract
Background: Central pancreatectomy is a surgical procedure for benign and low-grade malignant tumors which located in the neck and proximal body of the pancreas that facilitates the preservation of pancreatic endocrine and exocrine functions but has a high morbidity rate, especially postoperative pancreatic fistula (POPF). The aim of this systematic review and meta-analysis was to evaluate the safety and effectiveness between minimally invasive central pancreatectomy (MICP) and open central pancreatectomy (OCP) basing on perioperative outcomes. Methods: An extensive literature search to compare MICP and OCP was conducted from October 2003 to October 2023 on PubMed, Medline, Embase, Web of Science, and the Cochrane Library. Fixed-effect models or random effects were selected based on heterogeneity, and pooled odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Results: A total of 10 studies with a total of 510 patients were included. There was no significant difference in POPF between MICP and OCP (OR = 0.95; 95% CI [0.64, 1.43]; P = 0.82), whereas intraoperative blood loss (MD = − 125.13; 95% CI [− 194.77, -55.49]; P < 0.001) and length of hospital stay (MD = − 2.86; 95% CI [− 5.00, − 0.72]; P = 0.009) were in favor of MICP compared to OCP, and there was a strong trend toward a lower intraoperative transfusion rate in MICP than in OCP (MD = 0.34; 95% CI [0.11, 1.00]; P = 0.05). There was no significant difference in other outcomes between the two groups. Conclusion: MICP was as safe and effective as OCP and had less intraoperative blood loss and a shorter length of hospital stay. However, further studies are needed to confirm the results. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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