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Meta-Analysis
. 2016 Oct;142(10):2173-83.
doi: 10.1007/s00432-016-2180-x. Epub 2016 May 23.

Robot-assisted surgery versus conventional laparoscopic surgery for endometrial cancer: a systematic review and meta-analysis

Weimin Xie  1 , Dongyan Cao  1 , Jiaxin Yang  2 , Keng Shen  1 , Lin Zhao  1
Affiliations
Meta-Analysis

Robot-assisted surgery versus conventional laparoscopic surgery for endometrial cancer: a systematic review and meta-analysis

Weimin Xie et al. J Cancer Res Clin Oncol. 2016 Oct.

Abstract

Purpose: To compare perioperative outcomes between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS) for the treatment of endometrial cancer by conducting a meta-analysis.

Methods: We searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE up to January 8, 2016. Studies clearly documenting a comparison between RAS and CLS for patients with endometrial cancer were included. The perioperative outcomes of interest included intraoperative visceral injuries, postoperative complications, operation time, estimated blood loss (EBL), blood transfusion, total lymph nodes harvested (TLNH), conversion to laparotomy, and length of hospital stay. The weighted mean difference (WMD) and odds ratio (OR) were pooled with either a fixed-effects or a random-effects model.

Results: A total of 19 studies were included in the analysis, involving 3056 patients. The pooled analysis showed that RAS was associated with lower EBL (WMD -77.65; 95 % confidence interval [CI] -105.58 to -49.72), lower conversion rate (OR 0.29; 95 % CI 0.18-0.46), and shorter hospital stay (WMD -0.48; 95 % CI -0.70 to -0.26) compared to CLS. The incidence of intraoperative visceral injuries, operation time, transfusion rate, and TLNH showed no significant differences between RAS and CLS.

Conclusions: RAS is a feasible and effective surgical approach that may be superior to CLS for the treatment of endometrial cancer, with lower EBL and lower conversion rate. Further prospective randomized trials are required to validate our findings.

Keywords: Conventional laparoscopic surgery; Endometrial cancer; Meta-analysis; Perioperative outcomes; Robot-assisted surgery.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Forest plot of intraoperative visceral injuries between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS)
Fig. 3
Fig. 3
Forest plot of operation time between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS)
Fig. 4
Fig. 4
Forest plot of estimated blood loss (EBL) between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS)
Fig. 5
Fig. 5
Forest plot of blood transfusion between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS)
Fig. 6
Fig. 6
Forest plot of total lymph nodes harvested (TLNH) between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS)
Fig. 7
Fig. 7
Forest plot of conversion between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS)
Fig. 8
Fig. 8
Forest plot of length of hospital stay between robot-assisted surgery (RAS) and conventional laparoscopic surgery (CLS)
Fig. 9
Fig. 9
Funnel plot for intraoperative visceral injuries
See this image and copyright information in PMC

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