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Perioperative and oncologic outcomes of robot-assisted versus open surgery for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis.
- Source :
-
Journal of robotic surgery [J Robot Surg] 2024 Jul 22; Vol. 18 (1), pp. 288. Date of Electronic Publication: 2024 Jul 22. - Publication Year :
- 2024
-
Abstract
- This systematic review and meta-analysis aimed to compare perioperative and oncologic outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) treated with robotic-assisted surgery versus open laparotomy. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs) and cohort studies up to June 15, 2024, were identified using PubMed, EMBASE, and Google Scholar. Additionally, reference lists of included studies, relevant review articles, and clinical guidelines were manually searched. The primary outcomes evaluated were length of stay, 90-day mortality, postoperative pancreatic fistula (POPF), and Post-pancreatectomy haemorrhage (PPH). Secondary outcomes included estimated blood loss, reoperation rate, lymph node yield, and operative time. The final analysis included 10 retrospective cohort studies involving 23,272 patients (2,179 robotic-assisted and 21,093 open surgery). There were no significant differences between the two procedures in terms of postoperative pancreatic fistula, Post-pancreatectomy haemorrhage, lymph node yield, and operative time. However, patients undergoing robotic-assisted surgery had shorter lengths of stay, lower 90-day mortality, and less estimated blood loss compared to those undergoing open surgery. The reoperation rate was higher for the robotic-assisted group. Robotic-assisted surgery for pancreatic ductal adenocarcinoma is safe and feasible. Compared to open surgery, it offers better perioperative and short-term oncologic outcomes, but with a higher risk of reoperation.<br /> (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
- Subjects :
- Humans
Treatment Outcome
Postoperative Complications epidemiology
Postoperative Complications etiology
Operative Time
Pancreatic Fistula etiology
Pancreatic Fistula epidemiology
Blood Loss, Surgical statistics & numerical data
Reoperation statistics & numerical data
Laparotomy methods
Robotic Surgical Procedures methods
Robotic Surgical Procedures adverse effects
Carcinoma, Pancreatic Ductal surgery
Carcinoma, Pancreatic Ductal mortality
Pancreatic Neoplasms surgery
Pancreatic Neoplasms mortality
Pancreatectomy methods
Length of Stay statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1863-2491
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of robotic surgery
- Publication Type :
- Academic Journal
- Accession number :
- 39039276
- Full Text :
- https://doi.org/10.1007/s11701-024-02046-x