Pancreatic Complications After Conventional Laparoscopic Radical Gastrectomy Versus Robotic Radical Gastrectomy: Systematic Review and Meta-Analysis

J Laparoendosc Adv Surg Tech A. 2018 Oct;28(10):1207-1215. doi: 10.1089/lap.2018.0159. Epub 2018 May 7.

Abstract

Background: Recent reports have suggested that the use of the robot might reduce the rate of pancreatic complications following minimally invasive radical gastrectomy.

Methods: By meta-analyzing the available literature, we aimed to elucidate possible differences between conventional laparoscopic and robotic radical gastrectomy on pancreatic morbidity.

Results: More than 2000 patients from eight studies were eventually included in the analysis. The overall incidence of postoperative pancreatic complications was 2.2%, being 1.7% and 2.5% following robotic and laparoscopic gastrectomy (LG), respectively. In particular, pancreatic fistula occurred in 2.7% of patients receiving robotic gastrectomy (RG) and 3.8% of patients receiving laparoscopy.

Conclusions: The use of the robot showed a trend toward better outcomes compared with laparoscopy, despite the presence of more advanced disease and higher body mass index. The meta-analysis resulted in an odd ratio of 0.8 favoring RG over LG on pancreatic morbidity, although without statistical significance.

Keywords: gastric cancer; laparoscopic gastrectomy; minimally invasive gastrectomy; postoperative pancreatic fistula; robotic gastrectomy.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Humans
  • Incidence
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Middle Aged
  • Pancreas / surgery
  • Pancreatic Diseases / epidemiology*
  • Pancreatic Diseases / etiology
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Robotic Surgical Procedures / adverse effects*
  • Robotic Surgical Procedures / methods
  • Robotics
  • Stomach Neoplasms / surgery
  • Treatment Outcome