Clinical efficacy and safety of robotic distal gastrectomy for gastric cancer: a systematic review and meta-analysis

Gong, Sheng; Li, Xiong; Tian, Hongwei; Song, Shaoming; Lu, Tingting; Jing, Wutang; Huang, Xianbin; Xu, Yong; Wang, Xingqiang; Zhao, Kaihui; Yang, Kehu; Guo, Tiankang

doi:10.1007/s00464-021-08994-x

Cited by 14 publications

(50 citation statements)

References 42 publications

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“…Analysis involved all 224 studies: out of them, 193 ones turned as not relevant for title and abstract, while 31 full-texts were considered eligible. Twe of the 31 studies were excluded because they were identified as duplicate publicati After removal of 4 studies not complying with inclusion criteria (1 robotic gastrecto versus open gastrectomy meta-analysis; 1 umbrella review; 1 umbrella review protoc network meta-analysis), 7 meta-analyses underwent qualitative synthesis [14][15][16][17][18][19][20]. No ditional record was found through other source (References list).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: General Population Characteristicsmentioning

confidence: 99%

“…Table 1 shows demographic features of 7 included meta-analyses that covered 2000-2020 time frame [14][15][16][17][18][19][20]. Studies included into the meta-analyses ranged from 12 to 40, were almost all retrospective ones and originated from Asian countries (China and Korea, in particular) [14][15][16][17][18][19][20]. Examined overall population ranged from 3176 to 17,712 patients; in all studies, the laparoscopic subgroup turned out as more represented than the robotic one [14][15][16][17][18][19][20].…”

Section: General Population Characteristicsmentioning

confidence: 99%

“…Studies included into the meta-analyses ranged from 12 to 40, were almost all retrospective ones and originated from Asian countries (China and Korea, in particular) [14][15][16][17][18][19][20]. Examined overall population ranged from 3176 to 17,712 patients; in all studies, the laparoscopic subgroup turned out as more represented than the robotic one [14][15][16][17][18][19][20]. Almost all researches detailed surgical adopted procedure, with a prevalence of distal and total gastrectomy [14][15][16][17][18][19][20].…”

Section: General Population Characteristicsmentioning

confidence: 99%

“…Examined overall population ranged from 3176 to 17,712 patients; in all studies, the laparoscopic subgroup turned out as more represented than the robotic one [14][15][16][17][18][19][20]. Almost all researches detailed surgical adopted procedure, with a prevalence of distal and total gastrectomy [14][15][16][17][18][19][20].…”

Section: General Population Characteristicsmentioning

confidence: 99%

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Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review

et al. 2022

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Background and Objectives: Gastrectomy with D2 lymphadenectomy is the standard surgical treatment with curative intent for patients with gastric cancer (GC). Over the last three decades, surgeons have been increasingly adopting laparoscopic surgery for GC, due to its better short-term outcomes. In particular, laparoscopic gastrectomy (LG) has been routinely used for early gastric cancer (EGC) treatment. However, LG suffers from technical limitations and drawbacks, such as a two-dimensional surgical field of view, limited movement of laparoscopic tools, unavoidable physiological tremors and discomfort for operating surgeon. Therefore, robotic surgery has been developed to address such limitations. Materials and Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines in order to investigate the benefits and harms of robotic gastrectomy (RG) compared to the LG. PubMed/MEDLINE, Scopus, Cochrane Library (Cochrane Database of Systematic Re-views, Cochrane Central Register of Controlled Trials-CENTRAL) and Web of Science (Science and Social Science Citation Index) databases were used to search all related literature. Results: The 7 included meta-analyses covered an approximately 20 years-study period (2000–2020). Almost all studies included in the meta-analyses were retrospective ones and originated from Asian countries (China and Korea, in particular). Examined overall population ranged from 3176 to 17,712 patients. If compared to LG, RG showed both operative advantages (operative time, estimated blood loss, number of retrieved lymph nodes) and perioperative ones (time to first flatus, time to restart oral intake, length of hospitalization, overall complications, Clavien-Dindo (CD) ≥ III complications, pancreatic complications), in the absence of clear differences of oncological outcomes. However, costs of robotic approach appear significant. Conclusions: It is impossible to make strong recommendations, due to the statistical weakness of the included studies. Further randomized, possibly multicenter trials are strongly recommended, if we want to have our results confirmed.

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