Ouyang Lanwei, Zhang Jia, Feng Qingbo, Zhang Zhiguang, Ma Hexing, Zhang Guodong
Department of Thoracic Surgery, The 3rd Affiliated Hospital Of Chengdu Medical College, Pidu District People's Hospital, Chengdu, China.
Department of Breast Surgery, West China Hospital of Sichuan University, Chengdu, China.
Front Oncol. 2022 Feb 25;12:834382. doi: 10.3389/fonc.2022.834382. eCollection 2022.
Although minimally invasive pancreaticoduodenectomy has gained worldwide interest, there are limited comparative studies between two minimally invasive pancreaticoduodenectomy techniques. This meta-analysis aimed to compare the safety and efficacy of robotic and laparoscopic pancreaticoduodenectomy (LPD), especially the difference in the perioperative and short-term oncological outcomes.
PubMed, China National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, and EMBASE were searched based on a defined search strategy to identify eligible studies before July 2021. Data on operative times, blood loss, overall morbidity, major complications, vascular resection, blood transfusion, postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), conversion rate, reoperation, length of hospital stay (LOS), and lymph node dissection were subjected to meta-analysis.
Overall, the final analysis included 9 retrospective studies comprising 3,732 patients; 1,149 (30.79%) underwent robotic pancreaticoduodenectomy (RPD), and 2,583 (69.21%) underwent LPD. The present meta-analysis revealed nonsignificant differences in operative times, overall morbidity, major complications, blood transfusion, POPF, DGE, reoperation, and LOS. Alternatively, compared with LPD, RPD was associated with less blood loss (p = 0.002), less conversion rate (p < 0.00001), less vascular resection (p = 0.0006), and more retrieved lymph nodes (p = 0.01).
RPD is at least equivalent to LPD with respect to the incidence of complication, incidence and severity of DGE, and reoperation and length of hospital stay. Compared with LPD, RPD seems to be associated with less blood loss, lower conversion rate, less vascular resection, and more retrieved lymph nodes.
https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD2021274057.
尽管微创胰十二指肠切除术已引起全球关注，但两种微创胰十二指肠切除技术之间的比较研究有限。本荟萃分析旨在比较机器人辅助和腹腔镜胰十二指肠切除术（LPD）的安全性和有效性，特别是围手术期和短期肿瘤学结局的差异。
根据既定的检索策略，检索了PubMed、中国知网（CNKI）、万方数据、Web of Science和EMBASE，以识别2021年7月之前的符合条件的研究。对手术时间、失血量、总体发病率、主要并发症、血管切除、输血、术后胰瘘（POPF）、胃排空延迟（DGE）、转化率、再次手术、住院时间（LOS）和淋巴结清扫的数据进行荟萃分析。
总体而言，最终分析纳入了9项回顾性研究，共3732例患者；1149例（30.79%）接受了机器人辅助胰十二指肠切除术（RPD），2583例（69.21%）接受了LPD。本荟萃分析显示，在手术时间、总体发病率、主要并发症、输血、POPF、DGE、再次手术和LOS方面无显著差异。另外，与LPD相比，RPD的失血量更少（p = 0.002），转化率更低（p < 0.00001），血管切除更少（p = 0.0006），获取的淋巴结更多（p = 0.01）。
在并发症发生率、DGE的发生率和严重程度、再次手术和住院时间方面，RPD至少与LPD相当。与LPD相比，RPD似乎失血量更少、转化率更低、血管切除更少且获取的淋巴结更多。
https://www.crd.york.ac.uk/PROSPERO/#recordDetails，标识符CRD2021274057。
