Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis
Background Robotic surgery, an emerging technology, has some potential advantages in many complicated endoscopic procedures compared with laparoscopic surgery. But robot-assisted cholecystectomy (RAC) is still a controversial issue on its comparative merit compared with conventional laparoscopic cho...
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Veröffentlicht in: | Surgical endoscopy 2018-11, Vol.32 (11), p.4377-4392 |
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creator | Han, Caiwen Shan, Xinyi Yao, Liang Yan, Peijing Li, Meixuan Hu, Lidong Tian, Hongwei Jing, Wutang Du, Binbin Wang, Lixia Yang, Kehu Guo, Tiankang |
description | Background
Robotic surgery, an emerging technology, has some potential advantages in many complicated endoscopic procedures compared with laparoscopic surgery. But robot-assisted cholecystectomy (RAC) is still a controversial issue on its comparative merit compared with conventional laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the safety and efficacy of RAC compared with LC for benign gallbladder disease.
Methods
A systematic literature search was conducted using the PubMed, EMBASE, and Cochrane Library databases (from their inception to December 2017) to obtain comparative studies assessing the safety and efficacy between RAC and LC. The quality of the literature was assessed, and the data analyzed using R software, random effects models were applied.
Results
Twenty-six studies, including 5 RCTs and 21 NRCSs (3 prospective plus 18 retrospective), were included. A total of 4004 patients were included, of which 1833 patients (46%) underwent RAC and 2171 patients (54%) underwent LC. No significant differences were found in intraoperative complications, postoperative complications, readmission rate, hospital stay, estimated blood loss, and conversion rate between RAC and LC groups. However, RAC was related to longer operative time compared with LC (MD = 12.04 min, 95% CI 7.26–16.82) in RCT group, which was consistent with NRCS group; RAC also had a higher rate of incisional hernia in NRCS group (RR = 3.06, 95% CI 1.42–6.57), and one RCT reported that RAC was similar to LC (RR = 7.00, 95% CI 0.38–129.84).
Conclusions
The RAC was not found to be more effective or safer than LC for benign gallbladder diseases, which indicated that RAC is a developing procedure instead of replacing LC at once. Given the higher costs, the current evidence is in favor of LC in cholecystectomy. |
doi_str_mv | 10.1007/s00464-018-6295-9 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2062835949</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2062835949</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-eb3c26daed41a015c499ff50edac39404fb19ebad35a1a4bf484b719bf5ff9d3</originalsourceid><addsrcrecordid>eNp1kUFrFDEUgIModlv9AV4k4MVLNMkksxNvUrQKBUF6H16Sl3XKzGTNm2lZ_PNm3aogeMrhffleyMfYCyXfKCm3b0lK0xohVSda7axwj9hGmUYLrVX3mG2ka6TQW2fO2DnRray4U_YpO9PO2VbqbsN-fM0-L0MQQDTQgpHfYaGV-Ah7KJlC3g-Bh295xHCo87Dk6cBTLtzjPOxmvoNx9CPEiIXHgRAI6R0HTkd6gqrmBe8GvOcwRz7hAgJmGA912zP2JMFI-PzhvGA3Hz_cXH4S11-uPl--vxah2epFoG-CbiNgNAqkssE4l5KVGCE0zkiTvHLoITYWFBifTGf8VjmfbEouNhfs9Um7L_n7irT000ABxxFmzCv1Wra6a6wzrqKv_kFv81rqc39RSmtrla2UOlGhfhAVTP2-DBOUQ69kfwzTn8L0NUx_DNMfzS8fzKufMP658btEBfQJoDqad1j-rv6_9SeYYpwy</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2061225515</pqid></control><display><type>article</type><title>Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis</title><source>SpringerNature Journals</source><creator>Han, Caiwen ; Shan, Xinyi ; Yao, Liang ; Yan, Peijing ; Li, Meixuan ; Hu, Lidong ; Tian, Hongwei ; Jing, Wutang ; Du, Binbin ; Wang, Lixia ; Yang, Kehu ; Guo, Tiankang</creator><creatorcontrib>Han, Caiwen ; Shan, Xinyi ; Yao, Liang ; Yan, Peijing ; Li, Meixuan ; Hu, Lidong ; Tian, Hongwei ; Jing, Wutang ; Du, Binbin ; Wang, Lixia ; Yang, Kehu ; Guo, Tiankang</creatorcontrib><description>Background
Robotic surgery, an emerging technology, has some potential advantages in many complicated endoscopic procedures compared with laparoscopic surgery. But robot-assisted cholecystectomy (RAC) is still a controversial issue on its comparative merit compared with conventional laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the safety and efficacy of RAC compared with LC for benign gallbladder disease.
Methods
A systematic literature search was conducted using the PubMed, EMBASE, and Cochrane Library databases (from their inception to December 2017) to obtain comparative studies assessing the safety and efficacy between RAC and LC. The quality of the literature was assessed, and the data analyzed using R software, random effects models were applied.
Results
Twenty-six studies, including 5 RCTs and 21 NRCSs (3 prospective plus 18 retrospective), were included. A total of 4004 patients were included, of which 1833 patients (46%) underwent RAC and 2171 patients (54%) underwent LC. No significant differences were found in intraoperative complications, postoperative complications, readmission rate, hospital stay, estimated blood loss, and conversion rate between RAC and LC groups. However, RAC was related to longer operative time compared with LC (MD = 12.04 min, 95% CI 7.26–16.82) in RCT group, which was consistent with NRCS group; RAC also had a higher rate of incisional hernia in NRCS group (RR = 3.06, 95% CI 1.42–6.57), and one RCT reported that RAC was similar to LC (RR = 7.00, 95% CI 0.38–129.84).
Conclusions
The RAC was not found to be more effective or safer than LC for benign gallbladder diseases, which indicated that RAC is a developing procedure instead of replacing LC at once. Given the higher costs, the current evidence is in favor of LC in cholecystectomy.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-018-6295-9</identifier><identifier>PMID: 29956028</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Cholecystectomy ; Gallbladder ; Gallbladder diseases ; Gastroenterology ; Gynecology ; Hepatology ; Laparoscopy ; Medicine ; Medicine & Public Health ; Meta-analysis ; Proctology ; Review Article ; Robotic surgery ; Surgery ; Systematic review</subject><ispartof>Surgical endoscopy, 2018-11, Vol.32 (11), p.4377-4392</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Surgical Endoscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-eb3c26daed41a015c499ff50edac39404fb19ebad35a1a4bf484b719bf5ff9d3</citedby><cites>FETCH-LOGICAL-c372t-eb3c26daed41a015c499ff50edac39404fb19ebad35a1a4bf484b719bf5ff9d3</cites><orcidid>0000-0001-6679-8674</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-018-6295-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-018-6295-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29956028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Han, Caiwen</creatorcontrib><creatorcontrib>Shan, Xinyi</creatorcontrib><creatorcontrib>Yao, Liang</creatorcontrib><creatorcontrib>Yan, Peijing</creatorcontrib><creatorcontrib>Li, Meixuan</creatorcontrib><creatorcontrib>Hu, Lidong</creatorcontrib><creatorcontrib>Tian, Hongwei</creatorcontrib><creatorcontrib>Jing, Wutang</creatorcontrib><creatorcontrib>Du, Binbin</creatorcontrib><creatorcontrib>Wang, Lixia</creatorcontrib><creatorcontrib>Yang, Kehu</creatorcontrib><creatorcontrib>Guo, Tiankang</creatorcontrib><title>Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Robotic surgery, an emerging technology, has some potential advantages in many complicated endoscopic procedures compared with laparoscopic surgery. But robot-assisted cholecystectomy (RAC) is still a controversial issue on its comparative merit compared with conventional laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the safety and efficacy of RAC compared with LC for benign gallbladder disease.
Methods
A systematic literature search was conducted using the PubMed, EMBASE, and Cochrane Library databases (from their inception to December 2017) to obtain comparative studies assessing the safety and efficacy between RAC and LC. The quality of the literature was assessed, and the data analyzed using R software, random effects models were applied.
Results
Twenty-six studies, including 5 RCTs and 21 NRCSs (3 prospective plus 18 retrospective), were included. A total of 4004 patients were included, of which 1833 patients (46%) underwent RAC and 2171 patients (54%) underwent LC. No significant differences were found in intraoperative complications, postoperative complications, readmission rate, hospital stay, estimated blood loss, and conversion rate between RAC and LC groups. However, RAC was related to longer operative time compared with LC (MD = 12.04 min, 95% CI 7.26–16.82) in RCT group, which was consistent with NRCS group; RAC also had a higher rate of incisional hernia in NRCS group (RR = 3.06, 95% CI 1.42–6.57), and one RCT reported that RAC was similar to LC (RR = 7.00, 95% CI 0.38–129.84).
Conclusions
The RAC was not found to be more effective or safer than LC for benign gallbladder diseases, which indicated that RAC is a developing procedure instead of replacing LC at once. Given the higher costs, the current evidence is in favor of LC in cholecystectomy.</description><subject>Abdominal Surgery</subject><subject>Cholecystectomy</subject><subject>Gallbladder</subject><subject>Gallbladder diseases</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Proctology</subject><subject>Review Article</subject><subject>Robotic surgery</subject><subject>Surgery</subject><subject>Systematic review</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUFrFDEUgIModlv9AV4k4MVLNMkksxNvUrQKBUF6H16Sl3XKzGTNm2lZ_PNm3aogeMrhffleyMfYCyXfKCm3b0lK0xohVSda7axwj9hGmUYLrVX3mG2ka6TQW2fO2DnRray4U_YpO9PO2VbqbsN-fM0-L0MQQDTQgpHfYaGV-Ah7KJlC3g-Bh295xHCo87Dk6cBTLtzjPOxmvoNx9CPEiIXHgRAI6R0HTkd6gqrmBe8GvOcwRz7hAgJmGA912zP2JMFI-PzhvGA3Hz_cXH4S11-uPl--vxah2epFoG-CbiNgNAqkssE4l5KVGCE0zkiTvHLoITYWFBifTGf8VjmfbEouNhfs9Um7L_n7irT000ABxxFmzCv1Wra6a6wzrqKv_kFv81rqc39RSmtrla2UOlGhfhAVTP2-DBOUQ69kfwzTn8L0NUx_DNMfzS8fzKufMP658btEBfQJoDqad1j-rv6_9SeYYpwy</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Han, Caiwen</creator><creator>Shan, Xinyi</creator><creator>Yao, Liang</creator><creator>Yan, Peijing</creator><creator>Li, Meixuan</creator><creator>Hu, Lidong</creator><creator>Tian, Hongwei</creator><creator>Jing, Wutang</creator><creator>Du, Binbin</creator><creator>Wang, Lixia</creator><creator>Yang, Kehu</creator><creator>Guo, Tiankang</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6679-8674</orcidid></search><sort><creationdate>20181101</creationdate><title>Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis</title><author>Han, Caiwen ; Shan, Xinyi ; Yao, Liang ; Yan, Peijing ; Li, Meixuan ; Hu, Lidong ; Tian, Hongwei ; Jing, Wutang ; Du, Binbin ; Wang, Lixia ; Yang, Kehu ; Guo, Tiankang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-eb3c26daed41a015c499ff50edac39404fb19ebad35a1a4bf484b719bf5ff9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Cholecystectomy</topic><topic>Gallbladder</topic><topic>Gallbladder diseases</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Proctology</topic><topic>Review Article</topic><topic>Robotic surgery</topic><topic>Surgery</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Han, Caiwen</creatorcontrib><creatorcontrib>Shan, Xinyi</creatorcontrib><creatorcontrib>Yao, Liang</creatorcontrib><creatorcontrib>Yan, Peijing</creatorcontrib><creatorcontrib>Li, Meixuan</creatorcontrib><creatorcontrib>Hu, Lidong</creatorcontrib><creatorcontrib>Tian, Hongwei</creatorcontrib><creatorcontrib>Jing, Wutang</creatorcontrib><creatorcontrib>Du, Binbin</creatorcontrib><creatorcontrib>Wang, Lixia</creatorcontrib><creatorcontrib>Yang, Kehu</creatorcontrib><creatorcontrib>Guo, Tiankang</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han, Caiwen</au><au>Shan, Xinyi</au><au>Yao, Liang</au><au>Yan, Peijing</au><au>Li, Meixuan</au><au>Hu, Lidong</au><au>Tian, Hongwei</au><au>Jing, Wutang</au><au>Du, Binbin</au><au>Wang, Lixia</au><au>Yang, Kehu</au><au>Guo, Tiankang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>32</volume><issue>11</issue><spage>4377</spage><epage>4392</epage><pages>4377-4392</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Robotic surgery, an emerging technology, has some potential advantages in many complicated endoscopic procedures compared with laparoscopic surgery. But robot-assisted cholecystectomy (RAC) is still a controversial issue on its comparative merit compared with conventional laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the safety and efficacy of RAC compared with LC for benign gallbladder disease.
Methods
A systematic literature search was conducted using the PubMed, EMBASE, and Cochrane Library databases (from their inception to December 2017) to obtain comparative studies assessing the safety and efficacy between RAC and LC. The quality of the literature was assessed, and the data analyzed using R software, random effects models were applied.
Results
Twenty-six studies, including 5 RCTs and 21 NRCSs (3 prospective plus 18 retrospective), were included. A total of 4004 patients were included, of which 1833 patients (46%) underwent RAC and 2171 patients (54%) underwent LC. No significant differences were found in intraoperative complications, postoperative complications, readmission rate, hospital stay, estimated blood loss, and conversion rate between RAC and LC groups. However, RAC was related to longer operative time compared with LC (MD = 12.04 min, 95% CI 7.26–16.82) in RCT group, which was consistent with NRCS group; RAC also had a higher rate of incisional hernia in NRCS group (RR = 3.06, 95% CI 1.42–6.57), and one RCT reported that RAC was similar to LC (RR = 7.00, 95% CI 0.38–129.84).
Conclusions
The RAC was not found to be more effective or safer than LC for benign gallbladder diseases, which indicated that RAC is a developing procedure instead of replacing LC at once. Given the higher costs, the current evidence is in favor of LC in cholecystectomy.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29956028</pmid><doi>10.1007/s00464-018-6295-9</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0001-6679-8674</orcidid></addata></record> |
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subjects | Abdominal Surgery Cholecystectomy Gallbladder Gallbladder diseases Gastroenterology Gynecology Hepatology Laparoscopy Medicine Medicine & Public Health Meta-analysis Proctology Review Article Robotic surgery Surgery Systematic review |
title | Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis |
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