Robotic versus open pancreaticoduodenectomy: a meta-analysis of short-term outcomes
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Although robotic surgery is popular around the world, its safety and efficacy over classical open surgery is still controversial. The purpose of this article is to compare the safety and efficacy of robotic pancreaticoduodenectomy (RPD) and open pancreaticoduodenectomy (OPD).
A literature search of PubMed, Web of Science, and the Cochrane Library database up to July 29, 2018 was performed and the meta-analysis was performed using RevMan 5.2 software with Fixed and random effects models applied. The IRB approval and written consent were not needed for this paper.
Twelve non-randomized retrospective studies and 1 non-randomized prospective study consisting of 2403 patients were included in this meta-analysis. There were 788 (33%) patients in the RPD group and 1615 (67%) patients in the OPD group. Although RPD was associated with a longer operative time (weighted mean difference [WMD]: 71.74 min; 95% CI 23.37–120.12; p = 0.004), patient might benefit from less blood loss (WMD: − 374.03 ml; 95% CI − 506.84 to − 241.21; p < 0.00001), shorter length of stay (WMD: − 5.19 day; 95% CI − 8.42 to − 1.97; p = 0.002), and lower wound infection rate (odds ratio: 0.17; 95% CI 0.04–0.80; p = 0.02). No statistically significant difference was observed in positive margin rate, lymph nodes harvested, postoperative complications, reoperation or readmission rate, and mortality rate.
Robotic pancreaticoduodenectomy is a safe and feasible alternative to open pancreaticoduodenectomy with regard to short-term outcomes. Further studies on the long-term outcomes of these surgical techniques are needed.
KeywordsRobot Open Pancreaticoduodenectomy Meta-analysis
This work was supported by the Natural Science Foundation of China (81672412), the Natural Science Foundation of China (81772597), Science and Technology Program of Guangzhou, China (201607010111), the Guangdong Science and Technology Foundation (2017A020215196), the Guangdong Natural Science Foundation (2017A030311002), Pearl River S&T Nova Program of Guangzhou, China (201610010022), Fundamental Research Funds for the Central Universities of Sun Yat-sen University (17ykpy44), Grant 163 from Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology, Grant KLB09001 from the Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, and Grant from Guangdong Science and Technology Department (2015B050501004).
Compliance with ethical standards
Drs. Qing Yan, Lei-bo Xu, Ze-fang Ren, and Chao Liu have no conflicts of interest or financial ties to disclose.
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