Robot-assisted vs laparoscopy-assisted gastrectomy for gastric cancer: A meta-analysis based on 3518 subjects |
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Authors: | Zhi-Dong Lin Mao Liu Dan Tang Huan Li Bai-Meng Zhang |
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Institution: | Zhi-Dong Lin, Dan Tang, Bai-Meng Zhang, Department of General Surgery, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong Province, ChinaMao Liu, Department of Cardiology, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong Province, ChinaHuan Li, Sun Yat-Sen University Cancer Center, Guangzhou 510060, Guangdong Province, China |
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Abstract: | AIM: To compare the short-term clinical outcomes of robot-assisted gastrectomy(RAG) with laparoscopyassisted gastrectomy(LAG) in gastric cancer patients.METHODS: Articles were identified through a literature search of Pubmed, EMBASE, Scopus, Web of Science, Chinese National Knowledge Infrastructure and the Cochrane Library. Weighted mean differences(WMDs) and odds ratios(ORs) were selected as effect sizes for quantitative variables and qualitative variables, respectively. And 95%CIs were also calculated.RESULTS: A total of 13 studies with 3518 patients were included. RAG was associated with longer operative time(WMD = 46.26 min, 95%CI: 31.89-60.63, P 0.00001), less blood loss WMD =-37.19 m L, 95%CI:-60.16-(-14.23), P = 0.002] and shorter postoperative hospital stay WMD =-0.65 d, 95%CI:-1.24-(-0.05), P = 0.03] than LAG. No significant difference in the numbers of retrieved lymph nodes was found between the two groups(WMD = 1.46, 95%CI:-0.19-3.10, P = 0.08). There was no significant difference in mortality(OR = 1.55, 95%CI: 0.49-4.94, P = 0.45), overall complications(OR = 1.00, 95%CI: 0.80-1.26, P = 0.98), anastomosis leakage(OR = 1.02, 95%CI: 0.62-1.65, P = 0.95) and anastomosis stenosis rates(OR = 0.54, 95%CI: 0.18-1.57, P = 0.25). CONCLUSION: RAG is effective and safe in the treatment of gastric cancer. RAG is a promising alternative to laparoscopic surgery. Long-term randomized controlled studies with large scale and improved designs are needed to further evaluate the long-term outcomes. |
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Keywords: | Gastric cancer Robot Laparoscopy Gastrectomy Meta-analysis |
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