Francesco Guerra1,2, Giuseppe Giuliani3, Diego Coletta4. 1. Ospedali Riuniti Marche Nord, Pesaro, Italy. fra.guerra.mail@gmail.com. 2. Misericordia Hospital, Grosseto, Italy. fra.guerra.mail@gmail.com. 3. Misericordia Hospital, Grosseto, Italy. 4. IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Abstract
PURPOSE: The objective of this study was to investigate the risk of conversion associated with conventional laparoscopic surgery (LAP) versus robot-assisted surgery (ROB) in patients undergoing abdominal oncological surgery. Possible differences between ROB and LAP on postoperative overall and major morbidity, operative time, and length of hospitalization were also assessed. METHODS: We included randomized controlled trials of LAP versus ROB surgery in patients with abdominal malignancy. We searched PubMed, EMBASE, and the Central registries through September 2020. Risk of bias was estimated concerning randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases. RESULTS: A total of 1867 patients from 12 trials were included in this review. The rate of conversion was significantly higher for LAP than for ROB patients (10 trials, 1447 participants, p = 0.03, OR = 0.56 [0.33, 0.95]). There was a nonsignificant advantage of ROB over LAP on the rate of overall postoperative morbidity (12 trials, 1867 participants, p = 0.32, OR = 0.83) and major morbidity (7 trials, 792 participants, p = 0.87, OR= 0.93). ROB was also associated with prolonged operative time and abbreviated postoperative hospitalization as compared to LAP (p = 0.002, MD = 27.87, and p = 0.04, MD = -0.57, respectively). CONCLUSIONS: According to the available highest level of evidence, the application of ROB decreases the incidence of unplanned conversion into an open procedure as compared to standard LAP in the setting of oncological minimally invasive surgery.
PURPOSE: The objective of this study was to investigate the risk of conversion associated with conventional laparoscopic surgery (LAP) versus robot-assisted surgery (ROB) in patients undergoing abdominal oncological surgery. Possible differences between ROB and LAP on postoperative overall and major morbidity, operative time, and length of hospitalization were also assessed. METHODS: We included randomized controlled trials of LAP versus ROB surgery in patients with abdominal malignancy. We searched PubMed, EMBASE, and the Central registries through September 2020. Risk of bias was estimated concerning randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases. RESULTS: A total of 1867 patients from 12 trials were included in this review. The rate of conversion was significantly higher for LAP than for ROBpatients (10 trials, 1447 participants, p = 0.03, OR = 0.56 [0.33, 0.95]). There was a nonsignificant advantage of ROB over LAP on the rate of overall postoperative morbidity (12 trials, 1867 participants, p = 0.32, OR = 0.83) and major morbidity (7 trials, 792 participants, p = 0.87, OR= 0.93). ROB was also associated with prolonged operative time and abbreviated postoperative hospitalization as compared to LAP (p = 0.002, MD = 27.87, and p = 0.04, MD = -0.57, respectively). CONCLUSIONS: According to the available highest level of evidence, the application of ROB decreases the incidence of unplanned conversion into an open procedure as compared to standard LAP in the setting of oncological minimally invasive surgery.
Authors: Stefano Amore Bonapasta; Paolo Checcacci; Francesco Guerra; Vita M Mirasolo; Luca Moraldi; Angelo Ferrara; Mario Annecchiarico; Andrea Coratti Journal: Minerva Chir Date: 2016-03-04 Impact factor: 1.000
Authors: Barbara Martino; Letizia Nitro; Loredana De Pasquale; Paolo Lozza; Alberto Maccari; Luca Castellani; Matilde Piazzoni; Matteo Cardellicchio; Antonio Mario Bulfamante; Carlotta Pipolo; Giovanni Felisati; Alberto Maria Saibene Journal: Int J Med Robot Date: 2022-06-05 Impact factor: 2.483