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

作     者：Stefano Caruso Alberto Patriti Franco Roviello Lorenzo De Franco Franco Franceschini Graziano Ceccarelli Andrea Coratti 

作者机构：Department of General Surgery and Surgical SpecialtiesUnit of General Surgery"Santa Maria Annunziata" HospitalLocal Health Unit Center Tuscany Company Department of SurgeryDivision of General SurgeryHospitals of Pesaro and Fano"Ospedali Riuniti Marche Nord" Hospital Company Department of MedicalSurgical and NeuroscienceUnit of General and Minimally Invasive SurgeryUniversity of Siena Department of Medicine and General SurgeryUnit of Minimally Invasive and General SurgeryLocal health Unit South-Est Tuscany Company"San Donato" Hospital Division of Oncological and Robotic General Surgery"Careggi" University Hospital 

出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)

年 卷 期：2017年第8卷第3期

页      面：273-284页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Robot-assisted gastrectomy Gastric resection Open gastrectomy Gastric cancer 

摘      要：AIM To evaluate the potential effectiveness of robot-assisted gastrectomy(RAG) in comparison to open gastrectomy(OG) for gastric cancer *** 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 *** 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 *** primary outcome measures were set for estimated blood loss,operative time,conversion rate,morbidity,and hospital *** among postoperative complications,wound infection,bleeding and anastomotic leakage were also *** 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 *** 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 *** 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.