Received Jun 4; Accepted Nov 1. This article has been cited by other articles in PMC. Associated Data No additional data are available and data sharing not applicable to this article.
Abstract Background Laparoscopic distal pancreatectomy LDP reduces postoperative morbidity, hospital stay and recovery as compared with open distal pancreatectomy. Many authors believe that robotic surgery can overcome the difficulties and technical limits of Click thanks to improved surgical manipulation and better visualization. Few studies in the literature have compared the two methods in terms of surgical and oncological outcome.
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The aim of this study was to compare the results of robotic RDP and laparoscopic distal pancreatectomy. Two Reviewers independently assessed the eligibility and quality of the studies.
The meta-analysis was conducted using either the fixed-effect or the random-effect dating site xx group results. Results Ten studies describing patients met the inclusion criteria.
This meta-analysis shows that the RDP group had a significantly higher rate of spleen preservation [OR 2. However, even if the RDP has a higher cost compared to LDP, it increases the rate of spleen preservation, reduces the risk of conversion to open surgery and is associated to shorter length of hospital stay.
Keywords: Pancreatic cancer, Distal pancreatectomy, Left pancreatectomy, Pancreatic resection, Robotic surgery, Laparoscopic surgery, Review, Meta-analysis Background Distal pancreatectomy DP is the mainstay surgical procedure for the treatment of body-tail tumors of the pancreas [ 1 ].
Laparoscopic distal pancreatectomy LDP is a relatively new dating site xx group results as compared with the well-established open distal pancreatectomy [ 45 ]. The first LDP was in fact performed by Cuscheri in [ 6 ]. Since many authors still consider LDP to be a complex operation because of technical problems linked to the vascular control and dissection of the pancreatic gland that is deeply located in the retroperitoneum, this has resulted in a delay in the spread of LDP when compared to other mini-invasive surgical operations.
Thanks to the improvement of technology and the experience gained in laparoscopic surgery, it has been shown that LDP has achieved oncological results comparable to open surgery, with an overlapping rate of morbidity, but with the advantage of small dating online safety image incisions, shorter hospital stay and faster recovery [ 7 — 10 ].
The exceptional development of computer technology and its consequent biomedical applications have enabled the creation of robotic surgery. Robotic distal pancreatectomy RDP is the most recent frontier of minimally invasive surgery applied to the surgical treatment of pancreatic tumors [ 1112 ].
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RDP was first performed by Melvin in [ 13 ]. Robotic surgery has theoretically made it possible to overcome the disadvantages of the laparoscopic approach to the pancreas. In fact, it allows optimal viewing through a dating site xx group results dimensional high definition surgical view, tremor filtration, large range of motion due to an https://gfmeetlove.info/category17/w89.php articulated endo-wrist, all associated with remarkable ergonomics for the surgeon who performs the procedure [ 14 ].
Nevertheless, robotic procedures seem to be longer and have higher costs without a clear advantage in terms of surgical and oncologic outcomes [ 1415 ]. Moreover, none of these has reached a uniform conclusion in terms of efficacy and safety [ 27 ].
We therefore performed a systematic review and meta-analysis in order to compare the results of laparoscopic vs robotic distal pancreatectomy. Methods Literature search strategies and study selection A systematic literature search was conducted independently by two authors G.
The search strategy was set up using the key words or text words combined with a Mesh Medical subject headings database search. The search was exploded using the related article term in Pubmed. In addition, the references of searched articles were manually cross-searched for additional publications, and captured citations were filtered for study design in order to identify all control studies.
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All data extraction was performed in duplicate. We included studies with more than five patients in each arm for comparison of clinical outcomes. Narrative reviews, case series or studies without matched groups were excluded.
No unpublished data, or non-English manuscripts or data were used. The methodological quality of case-control and dating site xx group results studies was assessed using the Newcastle-Ottawa scale [ 28 ]. Only studies that reached six points or more were considered qualitatively eligible for meta-analysis. To select the titles of relevant studies, abstracts and full text articles were screened. Quality assessment of the studies and inclusion criteria We planned to include only randomized controlled trials RCTs in this review.
However, we found no RCTs on the topic, so we performed a meta-analysis of observational studies. We included studies reported as full text, and studies published as abstract only. All studies with Robotic and Laparoscopic pancreatectomy were considered.
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Any etiology for distal pancreatectomy was eligible and there were no limitations because of race, gender or age. Two investigators independently reviewed the datings site xx group results for eligibility and extracted data for the analysis. Any disagreement was resolved through discussion and consensus of the study team. Distal pancreatectomy-related morbidities, such as pancreatic fistula PFbleeding rate and all Clavien-Dindo complications grade III or more were used as measures of outcome.
Surgical results such as conversion rate, spleen preservation, operative time, length of hospital.