Long-term oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: a meta-analysis

Pan, Jinghua; Zhou, Hong; Zhao, Xiaoxu; Ding, Hui; Qin, Li; Pan, Yun-long

doi:10.1007/s00464-017-5891-4

Cited by 24 publications

(12 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 12 ] reported a 5-year DFS rate of 68.73% for gastric cancer treated with RG. For DFS, our study included almost two and a half times more patients than previous meta-study,[ 22 ] but a comprehensive analysis showed no significant difference in DFS between the RG and LG groups. The results suggest that the DFS of gastric cancer treated with RG is similar to that of LG, based on the current evidence.…”

Section: Discussionmentioning

confidence: 95%

“…[ 6 11 12 ] Although RG has been used for many years in the treatment of gastric cancer, few studies have focused on the long-term follow-up oncological outcomes. [ 12 22 ] However, for doctors and patients, the long-term oncological outcomes is the most important concern.…”

Section: Discussionmentioning

confidence: 99%

“…reported that there was no significant difference in the overall survival (OS) and disease-free survival (DFS) between RG and LG groups, which included five studies and involved 1614 patients. [ 22 ] Recently, some new literature have been published. Hence, we performed this updated meta-analysis to study the long-term OS, DFS and post-operative recurrence rate in patients with gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pooled analysis of the oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer

Lin

Yang

et al. 2021

Journal of Minimal Access Surgery

View full text Add to dashboard Cite

Aim: Robotic gastrectomy (RG) is more and more widely used in the treatment of gastric cancer. However, the long-term oncological outcomes of RG have not been well evaluated. The aim of this study was to evaluate the long-term oncological outcomes of RG and laparoscopic gastrectomy (LG) in the treatment of gastric cancer. Materials and Methods: PubMed, China National Knowledge Infrastructure, Cochrane Library and EMBASE electronic databases were searched until August 2019. Eligible studies were analysed for comparison of oncological outcomes between RG and LG in patients with gastric cancer. Results: Eleven retrospective comparative studies, which included 1347 (32.52%) patients in the RG group and 2795 (67.48%) patients in the LG group, were selected for the analysis. Meta-analysis of the 11 included studies showed that there was no statistically significant difference in the OS between the RG and LG groups (hazard ratios [HRs] = 0.97, 95% confidence intervals [CIs] = 0.80–1.19, P = 0.80). Six studies evaluated disease-free survival (DFS), and pooled analysis showed that there was no statistically significant difference in DFS between RG group and LG group (HR = 0.94, 95% CIs = 0.72–1.23, P = 0.65). According to the odds ratio (OR) analysis, there was no significant difference in 3-year OS, 5-year OS, 3-year DFS and 5-year DFS between the RG and LG groups. Nine articles reported the recurrence rate, and the meta-analysis showed that there was no statistically significant difference between the RG and LG groups (OR = 0.88, 95% CIs = 0.69–1.12, P = 0.31). Conclusions: This meta-analysis indicated that the long-term oncological outcomes in the RG group were similar to that in the LG group.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pooled analysis of the oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer

Lin

Yang

et al. 2021

Journal of Minimal Access Surgery

View full text Add to dashboard Cite

show abstract

“…Laparoscopic gastrectomy (LG) has been routinely used for the treatment of GC, supported by strong evidence that LG is technically safe and leads to better short-term outcomes than conventional open gastrectomy for early stage gastric cancer [3][4][5][6][7][8][9][10][11][12]. However, diffusion of laparoscopic surgery is limited by technical difficulties regarding total gastrectomy procedure as well as D2 lymphadenectomy, that entails the removal of node stations along the celiac trunk, left gastric artery and hepatic pedicle [13,14]; these factors limit the execution of a correct D2 spleen-preserving laparoscopic gastrectomy (LG) for the treatment of advanced gastric cancer only to high-volume centres.…”

Section: Introductionmentioning

confidence: 99%

Robotic versus laparoscopic gastrectomy for gastric cancer: an umbrella review of systematic reviews and meta-analyses

et al. 2021

View full text Add to dashboard Cite

An umbrella review was performed to summarize literature data and to investigate benefits and harm of robotic gastrectomy (RG) compared to laparoscopic (LG) approach. To overcome the intrinsic limitations of laparoscopy, the robotic approach is claimed to facilitate lymph-node dissection and complex reconstruction after gastrectomy, to assure oncologic safety also in advanced gastric cancer. A literature search was conducted in PubMed, Cochrane and Embase databases for all meta-analyses published up to December 2019. The search strategy was previously published in a protocol. We selected fourteen meta-analyses comparing outcomes between LG and RG with curative intent in patients with diagnosis of resectable gastric cancer. We highlight that RG has a longer operation time, inferior blood loss, reduction in hospital stay and a more rapid recovery of bowel function. In meta-analyses with statistical significance the number of nodes removed in RG is higher than LG and the distal margin of resection is higher. There is no difference in terms of total complication rate, mortality, morbidity, anastomotic leakage, anastomotic stenosis, intestinal obstruction and in conversion rate to open technique. The safety and efficacy of robotic gastrectomy are not clearly supported by strong evidence, suggesting that the outcomes reported for each surgical technique need to be interpreted with caution, in particular for the meta-analyses in which the heterogeneity is large. Certainly, robotic gastrectomy is associated with shorter time to oral intake, lesser intraoperative bleeding and longer operation time with an acceptable level of evidence. On the other hand, the data regarding other outcomes are insufficient as well as non-significant, from an evidence point of view, to draw any robust conclusion.

show abstract

“…However, a safer D2 spleen-preserving laparoscopic gastrectomy (LG) for the treatment of advanced GC did not meet the same success and is currently available only in high-volume centres. Technical difficulties due to total gastrectomy procedure as well as D2 lymphadenectomy, entailing the removal of node stations along the celiac trunk, left gastric artery and hepatic pedicle, are advocated as limiting factor of laparoscopic surgery diffusion 13 14. In the modern era of surgical oncology, to overcome some intrinsic limitations of the traditional laparoscopy, robotic approach is advocated by some authors as able to facilitate complex reconstruction after gastrectomy and the lymph node dissection, so as to assure oncologic safety also in advanced GC patients 15–17.…”

Section: Introductionmentioning

confidence: 99%

Robotic versus laparoscopic gastrectomy for gastric cancer: protocol for umbrella review of systematic reviews and meta-analyses

et al. 2020

View full text Add to dashboard Cite

IntroductionLaparoscopic surgery has been adopted in some parts of the world as an innovative approach to the resection of gastric cancers. However, in the modern era of surgical oncology, to overcome intrinsic limitations of the traditional laparoscopy, the robotic approach is advocated as able to facilitate the lymph node dissection and complex reconstruction after gastrectomy, to assure oncologic safety also in advanced gastric cancer patients. Previous meta-analyses highlighted a lower complication rate as well as bleeding in the robotic approach group when compared with the laparoscopic one. This potential benefit must be balanced against an increased time of intervention. The aim of this umbrella review is to provide a comprehensive overview of the literature for surgeons and policymakers in order to evaluate the potential benefits and harms of robotic gastrectomy (RG) compared with the laparoscopic approach for gastric cancer.Methods and analysisWe will perform a comprehensive search of the PubMed, Cochrane and Embase databases for all articles published up to May 2019 and reference list of relevant publications for systematic review and meta-analyses comparing the outcomes of RG and laparoscopic gastrectomy in patients with gastric cancer. Studies will be selected by two independent reviewers based on prespecified eligibility criteria and the quality will be assessed according to AMSTAR (A MeaSurement Tool to Assess systematic Reviews) checklist. All information will be collected using piloted and standardised data-extraction forms in DistillerSR developed following the Joanna Briggs Institute’s recommended extraction items.Ethics and disseminationThis umbrella review will inform clinical and policy decisions regarding the benefits and harms of RG for treating gastric cancer. The results will be disseminated through a peer-reviewed publication, conference presentations and the popular press. Formal ethical approval is not required as primary data will not be collected.PROSPERO registration numberCRD42019139906.

show abstract

Long-term oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: a meta-analysis

Cited by 24 publications

References 31 publications

Pooled analysis of the oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer

Pooled analysis of the oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer

Robotic versus laparoscopic gastrectomy for gastric cancer: an umbrella review of systematic reviews and meta-analyses

Robotic versus laparoscopic gastrectomy for gastric cancer: protocol for umbrella review of systematic reviews and meta-analyses

Contact Info

Product

Resources

About