HPB Unit, Department of General and Digestive Surgery, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain.
General Surgery Department, Hospital Universitario HM Sanchinarro, HM Hospitales, Universidad CEU San Pablo, Madrid, Spain.
Int J Med Robot. 2021 Oct;17(5):e2295. doi: 10.1002/rcs.2295. Epub 2021 Jun 16.
The aim of this meta-analysis is to compare perioperative outcomes and costs of robotic and laparoscopic distal pancreatectomy (RDP and LDP).
In accordance with the PRISMA guidelines, we searched Medline, EMBASE, Cochrane and Web of Science for reports published before December 2020.
The literature search identified 11 papers (1 187 patients). RDP showed a lower conversion rate (odds ratio: 2.56, 95% confidence intervals [CI]: 1.31 to 5.00) with no significant differences in bleeding and operative time, complications ≥ Clavien-Dindo grade III, pancreatic fistulas and length of stay. Despite RDP presenting higher costs in all included studies, none of these differences were significant. However, RDP showed higher total costs than LDP (standardized mean differences [SMD]: -1.18, 95% CI: -1.97 to -0.39). A subgroup analysis according to the continent of origin showed that studies coming from Asian research groups kept showing significant differences (SMD: -2.62, 95% CI: -3.38 to -1.85), while Western groups did not confirm these findings.
Based on low-quality evidence, despite some potential technical advantages, RDP still seems to be costlier than LDP.
本荟萃分析旨在比较机器人辅助和腹腔镜辅助远端胰腺切除术（RDP 和 LDP）的围手术期结果和成本。
根据 PRISMA 指南，我们检索了 Medline、EMBASE、Cochrane 和 Web of Science 数据库，以获取截至 2020 年 12 月之前发表的报告。
文献检索共确定了 11 篇文献（1187 例患者）。RDP 的转换率较低（比值比：2.56，95%置信区间[CI]：1.31 至 5.00），但在出血和手术时间、≥Clavien-Dindo 分级 III 的并发症、胰瘘和住院时间方面无显著差异。尽管所有纳入的研究均显示 RDP 的成本更高，但这些差异均无统计学意义。然而，RDP 的总费用高于 LDP（标准化均数差值[SMD]：-1.18，95%CI：-1.97 至 -0.39）。根据起源洲的亚组分析显示，来自亚洲研究小组的研究仍显示出显著差异（SMD：-2.62，95%CI：-3.38 至 -1.85），而西方研究小组则未证实这些发现。
基于低质量证据，尽管 RDP 具有一些潜在的技术优势，但与 LDP 相比，RDP 似乎仍然更昂贵。
