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Robotic versus laparoscopic hepatectomy for malignancy: A systematic review and meta-analysis
Yingnan Hu1, Kaibo Guo2, Jingming Xu2
1The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China; Jieshou Hospital of Traditional Chinese Medicine, China.
Asian Journal of Surgery
|January 20, 2021
Summary
Robotic hepatectomy (RH) shows similar safety and efficacy to laparoscopic hepatectomy (LH) for liver cancer. RH is suitable for larger tumors and reduces open procedures, but involves longer operative times.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Hepatobiliary Surgery
Background:
- Liver resections are complex procedures for malignant tumors.
- Minimally invasive techniques like laparoscopic hepatectomy (LH) have gained traction.
- Robotic hepatectomy (RH) offers potential advantages in dexterity and visualization.
Purpose of the Study:
- To compare the clinical safety and efficacy of robotic hepatectomy (RH) versus conventional laparoscopic hepatectomy (LH) for malignancy.
- To synthesize existing evidence through a meta-analysis of comparative studies.
Main Methods:
- Systematic literature search of PubMed, EMBASE, Medline, and Cochrane Library up to September 2020.
- Inclusion of six comparative studies involving 1093 patients (345 RH, 748 LH).
- Meta-analysis performed using Stata14.0 to pool data and assess outcomes.
Main Results:
- RH was associated with longer operative time, larger tumor size, and a higher proportion of right hepatectomies compared to LH.
- RH demonstrated a significantly lower open procedure rate than LH.
- No significant differences were observed in estimated blood loss, hospital stay, complication rates, or R0 resection rates between RH and LH.
Conclusions:
- Robotic hepatectomy (RH) offers comparable safety and feasibility to laparoscopic hepatectomy (LH) for malignant liver tumors.
- RH is advantageous for managing larger tumors and achieving lower open conversion rates.
- Further multicenter, high-quality randomized controlled studies are needed to validate these findings.
