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Review
. 2021 May;406(3):607-612.
doi: 10.1007/s00423-021-02106-y. Epub 2021 Mar 20.

The risk of conversion in minimally invasive oncological abdominal surgery. Meta-analysis of randomized evidence comparing traditional laparoscopic versus robot-assisted techniques

Francesco Guerra  1   2 , Giuseppe Giuliani  3 , Diego Coletta  4
Affiliations
Review

The risk of conversion in minimally invasive oncological abdominal surgery. Meta-analysis of randomized evidence comparing traditional laparoscopic versus robot-assisted techniques

Francesco Guerra et al. Langenbecks Arch Surg. 2021 May.

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.

Keywords: Minimally invasive surgery; Robot-assisted surgery; Surgical oncology; Conversion.

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References

    1. Ng KT, Tsia AKV, Chong VYL (2019) Robotic versus conventional laparoscopic surgery for colorectal cancer: a systematic review and meta-analysis with trial sequential analysis. World J Surg 43:1146–1161 - DOI
    1. Crippa J, Grass F, Dozois EJ, Mathis KL, Merchea A, Colibaseanu DT, Kelley SR, Larson DW (2020) Robotic surgery for rectal cancer provides advantageous outcomes over laparoscopic approach: results from a large retrospective cohort. Ann Surg. https://doi.org/10.1097/SLA.0000000000003805 Epub ahead of print.
    1. Guerra F, Guadagni S, Pesi B, Furbetta N, Di Franco G, Palmeri M, Annecchiarico M, Eugeni E, Coratti A, Patriti A, Morelli L (2019) Outcomes of robotic liver resections for colorectal liver metastases. A multi-institutional analysis of minimally invasive ultrasound-guided robotic surgery. Surg Oncol 28:14–18 - DOI
    1. Crippa J, Grass F, Achilli P, Mathis KL, Kelley SR, Merchea A, Colibaseanu DT, Larson DW (2020) Risk factors for conversion in laparoscopic and robotic rectal cancer surgery. Br J Surg 107:560–566 - DOI
    1. Phan K, Kahlaee HR, Kim SH, Toh JWT (2019) Laparoscopic vs. robotic rectal cancer surgery and the effect on conversion rates: a meta-analysis of randomized controlled trials and propensity-score-matched studies. Tech Coloproctol 23:221–230 - DOI

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