Paschalis Gavriilidis1, Keith J Roberts2, Luca Aldrighetti3, Robert P Sutcliffe2. 1. Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, B15 2TH, UK. Electronic address: pgavrielidis@yahoo.com. 2. Department of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, B15 2TH, UK. 3. Division of Hepatobiliary Surgery, San Raffaele Hospital, Via Olgettina 60, 20132, Milan, Italy.
Abstract
BACKGROUND: The evidence of pairwise meta-analysis of Robotic Hepatectomy (RH) vs Laparoscopic Hepatectomy (LH) and RH vs Open Hepatectomy (OH) is inconclusive. Therefore, the aim of this study, was to compare the outcomes of RH, LH and OH by performing a network meta-analysis. METHODS: A systematic literature search was performed in the following databases: Pubmed, Google scholar, EMBASE and Cochrane library. Cost-effectiveness and survival benefits were selected as primary outcomes. RESULTS: The cost was less in OH compared to both minimally invasive procedures, LH demonstrated lower cost compared to RH, but the differences were not statistically significant. Both the RH and LH cohorts demonstrated significantly lower estimated blood loss, reduced major morbidity rate and shorter length of stay compared to OH cohort. The LH and OH cohorts demonstrated significantly shorter operative time and duration of clamping compared to the RH cohort. The LH cohort included significantly smaller tumours compared to the OH cohort. CONCLUSION: The present network meta-analysis, demonstrated that both RH and LH in malignant and benign conditions were associated with lower morbidity rates, shorter hospital stay and the procedure related costs were statistically nonsignificant between RH, LH and OH.
BACKGROUND: The evidence of pairwise meta-analysis of Robotic Hepatectomy (RH) vs Laparoscopic Hepatectomy (LH) and RH vs Open Hepatectomy (OH) is inconclusive. Therefore, the aim of this study, was to compare the outcomes of RH, LH and OH by performing a network meta-analysis. METHODS: A systematic literature search was performed in the following databases: Pubmed, Google scholar, EMBASE and Cochrane library. Cost-effectiveness and survival benefits were selected as primary outcomes. RESULTS: The cost was less in OH compared to both minimally invasive procedures, LH demonstrated lower cost compared to RH, but the differences were not statistically significant. Both the RH and LH cohorts demonstrated significantly lower estimated blood loss, reduced major morbidity rate and shorter length of stay compared to OH cohort. The LH and OH cohorts demonstrated significantly shorter operative time and duration of clamping compared to the RH cohort. The LH cohort included significantly smaller tumours compared to the OH cohort. CONCLUSION: The present network meta-analysis, demonstrated that both RH and LH in malignant and benign conditions were associated with lower morbidity rates, shorter hospital stay and the procedure related costs were statistically nonsignificant between RH, LH and OH.
Authors: Benedetto Ielpo; Mauro Podda; Fernando Burdio; Patricia Sanchez-Velazquez; Maria-Alejandra Guerrero; Javier Nuñez; Miguel Toledano; Salvador Morales-Conde; Julio Mayol; Manuel Lopez-Cano; Eloy Espín-Basany; Gianluca Pellino Journal: Front Surg Date: 2022-05-06
Authors: Andrew A Gumbs; Eric Lorenz; Tzu-Jung Tsai; Lee Starker; Joe Flanagan; Andrea Benedetti Cacciaguerra; Ng Jing Yu; Melinda Bajul; Elie Chouillard; Roland Croner; Mohammad Abu Hilal Journal: Cancers (Basel) Date: 2022-03-08 Impact factor: 6.639