Meta-Analysis
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2015; 21(27): 8441-8451
Published online Jul 21, 2015. doi: 10.3748/wjg.v21.i27.8441
Outcomes of robotic vs laparoscopic hepatectomy: A systematic review and meta-analysis
Roberto Montalti, Giammauro Berardi, Alberto Patriti, Marco Vivarelli, Roberto Ivan Troisi
Roberto Montalti, Giammauro Berardi, Roberto Ivan Troisi, Department of General and Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital and Medical School, 9000 Ghent, Belgium
Roberto Montalti, Marco Vivarelli, Department of Gastroenterology and Transplantation Surgery, Polytechnic University of Marche-Ospedali Riuniti, 60126 Ancona, Italy
Alberto Patriti, Division of General, Minimally Invasive and Robotic Surgery, General Hospital of Spoleto, 06049 Spoleto, Italy
Author contributions: Montalti R and Berardi G contributed to acquisition of data, analysis and interpretation of data, drafting the article and final approval; Patriti A and Vivarelli M interpretated data, revised the article and made final approval; Troisi RI contributed to conception and design of the study, critical revision, final approval of the manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Roberto Ivan Troisi, MD, PhD, FEBS, Professor, Department of General and Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital and Medical School, De Pintelaan 185, 2K12 IC, 9000 Ghent, Belgium. roberto.troisi@ugent.be
Telephone: +32-9-3325519 Fax: +32-9-3323891
Received: January 11, 2015
Peer-review started: January 12, 2015
First decision: March 10, 2015
Revised: March 25, 2015
Accepted: May 7, 2015
Article in press: May 7, 2015
Published online: July 21, 2015
Processing time: 191 Days and 15.4 Hours
Abstract

AIM: To perform a systematic review and meta-analysis on robotic-assisted vs laparoscopic liver resections.

METHODS: A systematic literature search was performed using PubMed, Scopus and the Cochrane Library Central. Participants of any age and sex, who underwent robotic or laparoscopic liver resection were considered following these criteria: (1) studies comparing robotic and laparoscopic liver resection; (2) studies reporting at least one perioperative outcome; and (3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measures were set for estimated blood loss, operative time, conversion rate, R1 resection rate, morbidity and mortality rates, hospital stay and major hepatectomy rates.

RESULTS: A total of 7 articles, published between 2010 and 2014, fulfilled the selection criteria. The laparoscopic approach was associated with a significant reduction in blood loss and lower operative time (MD = 83.96, 95%CI: 10.51-157.41, P = 0.03; MD = 68.43, 95%CI: 39.22-97.65, P < 0.00001, respectively). No differences were found with respect to conversion rate, R1 resection rate, morbidity and hospital stay.

CONCLUSION: Laparoscopic liver resection resulted in reduced blood loss and shorter surgical times compared to robotic liver resections. There was no difference in conversion rate, R1 resection rate, morbidity and length of postoperative stay.

Keywords: Laparoscopic liver resections; Robotic liver resections; Outcome; Systematic review; Meta-analysis

Core tip: No consensus is available in the literature about which technique between laparoscopic and robotic liver resection is more beneficial to the patient. This is the first systematic review and meta-analysis comparing laparoscopic and robotic liver resection. We investigated these two techniques in terms of estimated blood loss, operative time, conversion rate, R1 resection rate, morbidity and mortality rates, hospital stay and major hepatectomy rates.