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Robotic versus laparoscopic distal pancreatectomy - The first meta-analysis.
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2016 Jul; Vol. 18 (7), pp. 567-74. Date of Electronic Publication: 2016 May 20. - Publication Year :
- 2016
-
Abstract
- Background: Minimally invasive pancreaticoduodenectomy is considered hazardous for the majority of authors and minimally distal pancreatectomy is still a debated topic. The aim of this study was to compare robotic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP) using meta-analysis.<br />Method: EMBASE, Medline and PubMed were searched systematically to identify full-text articles comparing robotic and laparoscopic distal pancreatectomies. The meta-analysis was performed by using Review Manager 5.3.<br />Results: Nine studies fulfilled the inclusion criteria and included 637 patients (246 robotic and 391 laparoscopic). RDP had a shorter hospital length of stay by 1 day (P = 0.01). On the other hand, LDP had shorter operative time by 30 min, although this was statistically nonsignificant (P = 0.12). RDP showed a significantly increased readmission rate (P = 0.04). There was no difference in the conversion rate, incidence of postoperative pancreatic fistula, International Study Group of Pancreatic Fistula grade B-C rate, major morbidity, spleen preservation rate and perioperative mortality. All surgical specimens of RDP reported R0 negative margins, whereas 7 specimens in the LDP group had affected margins.<br />Conclusions: In terms of feasibility, safety and oncological adequacy, there is no essential difference between the two techniques so far. The 30 min longer operative time of the RDP is due to the docking and undocking of the robot. The shorter length of stay by 1 day should be judged in combination with the increased 90-day readmission rate.<br /> (Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Pancreatic Ductal mortality
Carcinoma, Pancreatic Ductal pathology
Chi-Square Distribution
Humans
Length of Stay
Margins of Excision
Middle Aged
Odds Ratio
Operative Time
Pancreatectomy adverse effects
Pancreatectomy mortality
Pancreatic Fistula etiology
Pancreatic Neoplasms mortality
Pancreatic Neoplasms pathology
Patient Readmission
Risk Factors
Splenectomy
Time Factors
Treatment Outcome
Young Adult
Carcinoma, Pancreatic Ductal surgery
Laparoscopy adverse effects
Laparoscopy mortality
Pancreatectomy methods
Pancreatic Neoplasms surgery
Robotic Surgical Procedures adverse effects
Robotic Surgical Procedures mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 18
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 27346136
- Full Text :
- https://doi.org/10.1016/j.hpb.2016.04.008