Robotic versus Laparoscopic Distal Pancreatectomy: A Meta-Analysis of Short-Term Outcomes

• Published in: PloS one 2016-03, Vol.11 (3), p.e0151189-e0151189
• Main Authors: Zhou, Jia-Yu, Xin, Chang, Mou, Yi-Ping, Xu, Xiao-Wu, Zhang, Miao-Zun, Zhou, Yu-Cheng, Lu, Chao, Chen, Rong-Gao
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Blood; Clinical trials; Clinical Trials as Topic; Comparative analysis; Complications; Conversion; Engineering and Technology; Epidemiology; Feasibility studies; Fistula; Fistulae; Gastroenterology; Hospitals; Humans; Laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Lymph nodes; Medicine; Medicine and Health Sciences; Meta-analysis; Mortality; Pancreas; Pancreatectomy; Pancreatectomy - adverse effects; Pancreatectomy - methods; Patient outcomes; Patients; People and Places; Physical Sciences; Preservation; Quality; Quality assessment; Research and Analysis Methods; Robotic surgery; Robotic Surgical Procedures - adverse effects; Robotic Surgical Procedures - methods; Robotics; Spleen; Studies; Surgery; Surgical outcomes; Systematic review; Transfusion
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0151189

To compare the safety and efficacy of robotic-assisted distal pancreatectomy (RADP) and laparoscopic distal pancreatectomy (LDP). A literature search of PubMed, EMBASE, and the Cochrane Library database up to June 30, 2015 was performed. The following key words were used: pancreas, distal pancreatectomy, pancreatic, laparoscopic, laparoscopy, robotic, and robotic-assisted. Fixed and random effects models were applied. Study quality was assessed using the Newcastle-Ottawa Scale. Seven non-randomized controlled trials involving 568 patients met the inclusion criteria. Compared with LDP, RADP was associated with longer operating time, lower estimated blood loss, a higher spleen-preservation rate, and shorter hospital stay. There was no significant difference in transfusion, conversion to open surgery, R0 resection rate, lymph nodes harvested, overall complications, severe complications, pancreatic fistula, severe pancreatic fistula, ICU stay, total cost, and 30-day mortality between the two groups. RADP is a safe and feasible alternative to LDP with regard to short-term outcomes. Further studies on the long-term outcomes of these surgical techniques are required. To date, there is no consensus on whether laparoscopic or robotic-assisted distal pancreatectomy is more beneficial to the patient. This is the first meta-analysis to compare laparoscopic and robotic-assisted distal pancreatectomy. We found that robotic-assisted distal pancreatectomy was associated with longer operating time, lower estimated blood loss, a higher spleen-preservation rate, and shorter hospital stay. There was no significant difference in transfusion, conversion to open surgery, overall complications, severe complications, pancreatic fistula, severe pancreatic fistula, ICU stay, total cost, and 30-day mortality between the two groups.