Robotic versus open pancreaticoduodenectomy: a meta-analysis of short-term outcomes

Yan, Qing; Xu, Lei-Bo; Ren, Ze-Fang; Liu, Chao

doi:10.1007/s00464-019-07084-3

Cited by 42 publications

(37 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The survival rate can be improved by increasing the number of lymph node dissections, clarifying lymph node metastasis, and guiding postoperative treatment [36,37]. This meta-analysis showed that the R0 resection rate and lymph node dissection of robotic surgery were not signi cant different from that of open surgery, which was consistent with the previous meta-analyses by Podda et al [29], but Zhao et al [31] and Yan et al [30]. Nevertheless, they may have partially overlapping patients, which may lead to bias.…”

Section: Sensitivity Analysis and Bias Risk Assessmentsupporting

confidence: 86%

“…The sensitivity analysis showed that other results were not reversed after sequential removal of each study. Four previous meta-analyses [28][29][30][31] discussed the safety and effectiveness of robot technology in pancreaticoduodenal surgery and concluded that pancreaticoduodenectomy is a safe and feasible alternative to open surgery. However, these meta-analyses also have some limitations.…”

Section: Sensitivity Analysis and Bias Risk Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

et al. 2020

View full text Add to dashboard Cite

Objectives: To compare the e cacy of robot-assisted pancreaticoduodenectomy with that of laparotomy. Methods: The PubMed, EMBASE, Cochrane Library, and other databases were searched for literature available from their respective inception dates up to May 2020 to nd studies comparing robot-assisted pancreaticoduodenectomy (RPD) with open pancreaticoduodenectomy (OPD). The RevMan 5.3 statistical software was used for analysis to evaluate surgical outcome and oncology safety. The combination ratio (RR) and weighted mean difference (WMD) and their 95% con dence intervals (CIs) were calculated using xed effect or random effect models. Results: 18 cohort studies from 16 medical centers were eligible with a total of 5795 patients including 1420 RPD group patients and 4375 OPD group patients. The RPD group fared better than the OPD group in terms of estimated blood loss (EBL) (WMD =-175.

show abstract

Section: Sensitivity Analysis and Bias Risk Assessmentsupporting

confidence: 86%

Section: Sensitivity Analysis and Bias Risk Assessmentmentioning

confidence: 99%

Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Four previous meta-analyses [28][29][30][31] discussed the safety and effectiveness of robot technology in pancreaticoduodenal surgery and concluded that pancreaticoduodenectomy is a safe and feasible alternative to open surgery. However, these meta-analyses also have some limitations.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy for Robot-Assisted Versus Open Pancreaticoduodenectomy: A Meta-Analysis of Multiple Worldwide Centers

Zhang

Che

2020

Preprint

View full text Add to dashboard Cite

Abstract Objectives: To compare the efficacy of robot-assisted pancreaticoduodenectomy with that of laparotomy.Methods: The PubMed, EMBASE, Cochrane Library, and other databases were searched for literature available from their respective inception dates up to May 2020 to find studies comparing robot-assisted pancreaticoduodenectomy (RPD) with open pancreaticoduodenectomy (OPD). The RevMan 5.3 statistical software was used for analysis to evaluate surgical outcome and oncology safety. The combination ratio (RR) and weighted mean difference (WMD) and their 95% confidence intervals (CIs) were calculated using fixed effect or random effect models.Results: 18 cohort studies from 16 medical centers were eligible with a total of 5795 patients including 1420 RPD group patients and 4375 OPD group patients. The RPD group fared better than the OPD group in terms of estimated blood loss (EBL) (WMD =-175.65, 95% CI (-251.85, -99.44), P<0.00001), wound infection rate (RR=0.60, 95%CI (0.44,0.81), P= 0.001), reoperation rate (RR=0.61, 95%CI (0.41,0.91), P=0.02), hospital day (WMD = -2.95, 95% CI (-5.33,-0.56), P = 0.02), intraoperative blood transfusion (RR = 0.56, 95% CI(0.42, 0.76), P=0.0001), overall complication (RR = 0.78, 95% CI(0.64,0.95), P = 0.01), and clinical pancreatic fistula (PF) (RR = 0.54, 95% CI(0.41,0.70), P < 0.0001). In terms of lymph node clearance (WMD = 0.48, 95% CI(-2.05,3.02), P = 0.71), R0 rate (RR = 1.05, 95% CI(1.00,1.11), P = 0.05), postoperative pancreatic fistula (POPF) (RR=1, 95% CI(0.85,1.19), P = 0.97), bile leakage (RR = 0.99, 95% CI(0.54,1.83), P = 0.98), delayed gastric emptying (DGE) (RR = 0.79, 95% CI(0.60,1.03), P = 0.08), mortality (RR = 0.82, 95% CI(0.62,1.10), P=0.19), and severe complication (RR = 0.98, 95% CI(0.71,1.36), P = 0.91), there were no significant differences between the two groups. Laparoscopic surgery was inferior to open surgery in terms of operational time (WMD = 80.85, 95% CI (16.09,145.61), P=0.01).Conclusions: RPD is not inferior to OPD, and it is even more advantageous for DGE, wound infection rate, reoperation rate, hospital stay, transfusion, overall complication and clinical PF. However, these findings need to be further verified by high-quality randomized controlled trials.

show abstract

“…In a retrospective observational study using the NSQIP database, Zimmerman et al 52 compared the short surgical outcomes among OPD (n = 6336, 92.8%), LPD (n = 280, 4.1%), and RPD (n = 211, 3.1%), and they concluded that LPD was independently associated with less morbidity after controlling for differences among the three groups. Studies of the oncologic efficacy of RPD have yielded equivalent results in terms of lymph node retrieval and positive margin status by meta‐analysis including various pancreatic pathologies 44–46 . The oncologic benefit on PDAC derived from RPD remains uncertain, because of insufficient pooled data 40–43 .…”

Section: Minimally Invasive Pancreatoduodenectomy (Mipd)mentioning

confidence: 99%

Current statement and safe implementation of minimally invasive surgery in the pancreas

Hayashi

Baba

2020

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Minimally invasive pancreatic resection (MIPR) has become very popular even in pancreatic surgery. Laparoscopic pancreatoduodenectomy (LPD) and laparoscopic distal pancreatectomy (LDP) were introduced in 1994 and 1996, respectively. 1,2 Robotic surgical systems had also already been established 20 years ago, and the first case of robotic distal pancreatectomy (RDP) was reported in 2002. 3 Nowadays, laparoscopic and robotic approaches are becoming popular in MIPR, and the Miami international evidence-based guidelines on MIPR were announced in 2020. 4 In the guidelines, minimally invasive distal pancreatectomy (MIDP) for benign and low-grade malignant tumors established a secure position over open distal pancreatectomy (ODP), since the former is associated with a shorter

show abstract

Robotic versus open pancreaticoduodenectomy: a meta-analysis of short-term outcomes

Cited by 42 publications

References 37 publications

Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers

Safety and Efficacy for Robot-Assisted Versus Open Pancreaticoduodenectomy: A Meta-Analysis of Multiple Worldwide Centers

Current statement and safe implementation of minimally invasive surgery in the pancreas

Contact Info

Product

Resources

About