Robot-assisted laparoscopic vs open gastrectomy for gastric cancer:Systematic review and meta-analysis

查看全文 作　　者：Stefano [1]Caruso;Alberto [2]Patriti;Franco [3]Roviello;Lorenzo De [3]Franco;Franco [1]Franceschini;Graziano [4]Ceccarelli;Andrea [5]Coratti

机构地区：[1]Department of General Surgery and Surgical Specialties,Unit of General Surgery,'Santa Maria Annunziata' Hospital,Local Health Unit Center Tuscany Company;[2]Department of Surgery,Division of General Surgery,Hospitals of Pesaro and Fano,'Ospedali Riuniti Marche Nord' Hospital Company;[3]Department of Medical,Surgical and Neuroscience,Unit of General and Minimally Invasive Surgery,University of Siena;[4]Department of Medicine and General Surgery,Unit of Minimally Invasive and General Surgery,Local health Unit South-Est Tuscany Company,'San Donato' Hospital;[5]Division of Oncological and Robotic General Surgery,'Careggi' University Hospital

出　　处：《World Journal of Clinical Oncology》索引2017年第8卷第3期,共12页

摘　　要：AIM To evaluate the potential effectiveness of robot-assisted gastrectomy(RAG) in comparison to open gastrectomy(OG) for gastric cancer patients.METHODS A comprehensive systematic literature search using PubM ed,EMBASE,and the Cochrane Library was carried out to identify studies comparing RAG and OG in gastric cancer.Participants of any age and sex were considered for inclusion in comparative studies of the two techniques independently from type of gastrectomy.A meta-analysis of short-term perioperative outcomes was performed to evaluate whether RAG is equivalent to OG.The primary outcome measures were set for estimated blood loss,operative time,conversion rate,morbidity,and hospital stay.Secondary among postoperative complications,wound infection,bleeding and anastomotic leakage were also analysed.RESULTS A total of 6 articles,5 retrospective and 1 randomized controlled study,involving 6123 patients overall,with 689(11.3%) cases submitted to RAG and 5434(88.7%) to OG,satisfied the eligibility criteria and were included in the meta-analysis.RAG was associated with longer operation time than OG(weighted mean difference 72.20 min;P < 0.001),but with reduction in blood loss and shorter hospital stay(weighted mean difference-166.83 mL and-1.97 d respectively;P < 0.001).No differences were found with respect to overall postoperative complications(P = 0.65),wound infection(P = 0.35),bleeding(P = 0.65),and anastomotic leakage(P = 0.06).The postoperative mortality rates were similar between the two groups.With respect to oncological outcomes,no statistical differences among the number of harvested lymph nodes were found(weighted mean difference-1.12;P = 0.10).CONCLUSION RAG seems to be a technically valid alternative to OG for performing radical gastrectomy in gastric cancer resulting in safe complications. 关键词：ROBOT-ASSISTED GASTRECTOMY GASTRIC RESECTION OPEN GASTRECTOMY GASTRIC cancer

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Robot-assisted laparoscopic vs open gastrectomy for gastric cancer:Systematic review and meta-analysis

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