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Robotic versus laparoscopic distal pancreatectomies: A systematic review and meta‐analysis on costs and perioperative outcome
Author(s) -
Martino Marcello,
Caruso Riccardo,
D'Ovidio Angelo,
NúñezAlfonsel Javier,
Burdió Pinilla Fernando,
Quijano Collazo Yolanda,
Vicente Emilio,
Ielpo Benedetto
Publication year - 2021
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2295
Subject(s) - perioperative , meta analysis , medicine , odds ratio , subgroup analysis , confidence interval , medline , cochrane library , distal pancreatectomy , web of science , general surgery , surgery , resection , political science , law
Aim The aim of this meta‐analysis is to compare perioperative outcomes and costs of robotic and laparoscopic distal pancreatectomy (RDP and LDP). Material and methods In accordance with the PRISMA guidelines, we searched Medline, EMBASE, Cochrane and Web of Science for reports published before December 2020. Results The literature search identified 11 papers (1 187 patients). RDP showed a lower conversion rate (odds ratio: 2.56, 95% confidence intervals [CI]: 1.31 to 5.00) with no significant differences in bleeding and operative time, complications ≥ Clavien–Dindo grade III, pancreatic fistulas and length of stay. Despite RDP presenting higher costs in all included studies, none of these differences were significant. However, RDP showed higher total costs than LDP (standardized mean differences [SMD]: −1.18, 95% CI: −1.97 to −0.39). A subgroup analysis according to the continent of origin showed that studies coming from Asian research groups kept showing significant differences (SMD: −2.62, 95% CI: −3.38 to −1.85), while Western groups did not confirm these findings. Conclusion Based on low‐quality evidence, despite some potential technical advantages, RDP still seems to be costlier than LDP.