Comparing Operative Outcomes and Resection Quality in Robotic vs Open Pancreaticoduodenectomy: A Meta-analysis of 54,000 Patients.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-01-29 DOI:10.1007/s12029-025-01177-0

Muhammad Hassan Waseem, Zain Ul Abideen, Rafia Durrani, Esha Dilawar, Mohammad Saboor Kamran, Hassan Tariq Butt, Haseeb Javed Khan, Abdul Ahad, Pakeeza Shakoor, Hema Kumari Jeswani, Syeda Aliza Kazmi, Ibrahim Mughees, Muhammad Ali, Muhammad Arslan Tariq, Shurjeel Uddin Qazi

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引用次数: 0

Abstract

Background: High morbidity and mortality make pancreaticoduodenectomy (PD) one of the most complicated surgical procedures. This meta-analysis aimed to compare the outcomes of robotic pancreaticoduodenectomy (RPD) versus open pancreaticoduodenectomy (OPD).

Method: A comprehensive literature search of PubMed, Cochrane Central, and Google Scholar was conducted from inception to November 2024. Studies comparing RPD and OPD in adults aged ≥ 18 years were included. Data for the outcomes of interest were extracted.

Results: Forty-one studies with a total of 54,287 patients were pooled. RPD is significantly superior to OPD in terms of overall postoperative complications (RR = 0.91, 95% CI: [0.86-0.97]; p = 0.001), wound infections (RR = 0.63, 95% CI: [0.49-0.81], p = 0.0004), estimated blood loss (WMD = -171.99 ml, 95% CI: [ -217.76 to -126.22], p < 0.01) and hospitalization duration (WMD = -1.33 days, 95% CI: [ -1.84 to -0.82], p < 0.01) with a longer operating time (WMD = 73.22 min, 95% CI: [56.20 to 90.23], p < 0.01).

Conclusion: In conclusion, RPD shows a lower risk of wound infections and overall postoperative morbidity compared to OPD. It has lower estimated blood loss, shorter hospitalization duration, and a longer operating time. The two approaches were comparable in terms of resection quality. More high-quality RCTs are required to draw definite conclusions.

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比较机器人胰十二指肠切除术与开放式胰十二指肠切除术的手术效果和切除质量：54,000例患者的荟萃分析。

背景：高发病率和死亡率使胰十二指肠切除术（PD）成为最复杂的外科手术之一。本荟萃分析旨在比较机器人胰十二指肠切除术（RPD）与开放式胰十二指肠切除术（OPD）的结果。方法：综合检索PubMed、Cochrane Central、谷歌Scholar网站自成立至2024年11月的文献。比较RPD和OPD在≥18岁成人中的研究被纳入。提取感兴趣结果的数据。结果：41项研究共纳入54,287例患者。RPD在总体术后并发症方面明显优于OPD (RR = 0.91, 95% CI: [0.86-0.97]；p = 0.001)，伤口感染（RR = 0.63, 95% CI: [0.49-0.81], p = 0.0004），估计失血量(WMD = -171.99 ml, 95% CI: [-217.76 ~ -126.22]， p结论：与OPD相比，RPD的伤口感染风险和术后总体发病率较低。预估失血量少，住院时间短，手术时间长。两种入路在切除质量方面具有可比性。需要更多高质量的随机对照试验来得出明确的结论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.