Jamjoum Ghader, Altoukhi Samar M, Alsulaimani Muntaha Sami, Alghamidi Fouad Abdulsalam S, Alqahtani Muath A, Aljedani Lina Saleh, Alahmari Ziyad Khalid, Maghrabi Ashraf
Department of Surgery, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Gastrointestinal Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
J Robot Surg. 2025 Jun 16;19(1):295. doi: 10.1007/s11701-025-02446-7.
Pancreatic resection is necessary to treat pancreatic diseases, especially malignancy. Minimally invasive procedures, including robotic (RPR) and laparoscopic (LPR) pancreatic resections, have grown in popularity due to their potential to improve recovery and lower morbidity. The aim of this study is to provide evidence-based data for clinical decision-making by systematically comparing RPR and LPR with respect to postoperative recovery, perioperative safety, and oncological outcomes. A systematic review and meta-analysis following PRISMA guidelines was conducted using PubMed, Google Scholar, Cochrane, and Web of Science. Two independent reviewers extracted data, and pooled prevalence was analyzed using a random-effects model. Heterogeneity was assessed with Higgins I and Cochran's Q test. A sensitivity analysis was done using R. Forty-six peer-reviewed articles with follow-up periods ranging from 3 to 288 months were included in this review. Robotic surgery was performed in 4.8%-67.6% of cases, with patient ages ranging from 30 to 70 years. A considerably shorter hospital stay (MD: - 0.72, P = 0.004) and a higher rate of conversion to open surgery (OR: 0.52, P < 0.00001) were associated with RPR. However, no significant differences were observed between RPR.and LPR in important outcomes, including resection rate, lymph node yield, overall complications, operating time, 90-day mortality, and postoperative complications. While RPR outperforms LPR in terms of conversion and hospital stay rates, it is not significantly superior in terms of oncological outcomes and morbidity rate. The high heterogeneity in the studies suggests the need for more research to determine the optimal minimally invasive technique for pancreatic surgery.
胰腺切除术是治疗胰腺疾病尤其是恶性肿瘤的必要手段。包括机器人辅助（RPR）和腹腔镜（LPR）胰腺切除术在内的微创手术，因其有望改善恢复情况并降低发病率而越来越受欢迎。本研究的目的是通过系统比较RPR和LPR在术后恢复、围手术期安全性和肿瘤学结果方面，为临床决策提供循证数据。按照PRISMA指南，使用PubMed、谷歌学术、Cochrane和科学网进行了系统综述和荟萃分析。两名独立评审员提取数据，并使用随机效应模型分析合并患病率。用Higgins I和Cochrane Q检验评估异质性。使用R进行敏感性分析。本综述纳入了46篇同行评议文章，随访期为3至288个月。4.8% - 67.6%的病例采用了机器人手术，患者年龄在30至70岁之间。RPR与住院时间显著缩短（MD：-0.72，P = 0.004）和转为开放手术的比例较高（OR：0.52，P < 0.00001）相关。然而，在重要结果方面，包括切除率、淋巴结获取量、总体并发症、手术时间、90天死亡率和术后并发症，RPR和LPR之间未观察到显著差异。虽然RPR在转为开放手术率和住院率方面优于LPR，但在肿瘤学结果和发病率方面并无显著优势。研究中的高异质性表明需要更多研究来确定胰腺手术的最佳微创手术技术。
