Systematic review and meta-analysis of robotic versus open hepatectomy

ANZ J Surg. 2019 Mar;89(3):165-170. doi: 10.1111/ans.14690. Epub 2018 Jun 26.

Abstract

Background: To date, there are few studies comparing the outcomes of robotic hepatectomy (RH) versus open hepatectomy (OH). We report the first systematic review and meta-analysis comparing the outcomes of RH versus OH.

Methods: A systemic review was performed of all comparative studies of RH versus OH that reported the perioperative outcome(s) of interest.

Results: Seven retrospective cohort studies were included. There was no significant difference in patients' baseline characteristics. RH was associated with a longer operation time (mean difference (MD) 61.47 min; 95% confidence interval (CI) (7.03, 115.91); P = 0.03), shorter hospital stay (MD -2.57 days; 95% CI (-3.31, -1.82); P < 0.001), lower costs, less overall (risk ratio (RR) 0.63; 95% CI (0.46, 0.86); P = 0.004), minor (RR 0.64; 95% CI (0.43, 0.95); P = 0.03) and major (RR 0.45; 95% CI (0.22, 0.94); P = 0.03) post-operative complications compared to OH.

Conclusion: RH had superior perioperative outcomes and was not cost prohibitive compared to OH, but had longer operation times.

Keywords: laparoscopic liver resection; open liver resection; robotic hepatectomy; robotic liver resection; systematic review.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Hepatectomy / adverse effects*
  • Hepatectomy / economics
  • Hepatectomy / statistics & numerical data*
  • Hepatectomy / trends
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / economics
  • Laparoscopy / statistics & numerical data
  • Length of Stay / trends
  • Odds Ratio
  • Operative Time
  • Perioperative Period / statistics & numerical data
  • Perioperative Period / trends
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Robotic Surgical Procedures / adverse effects*
  • Robotic Surgical Procedures / economics
  • Robotic Surgical Procedures / statistics & numerical data*
  • Robotic Surgical Procedures / trends
  • Treatment Outcome