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Review
. 2022 Jun 10;11(12):3332.
doi: 10.3390/jcm11123332.

Conventional Laparoscopy versus Robotic-Assisted Aortic Lymph-Nodal Staging for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Mariano Catello Di Donna  1   2 , Vincenzo Giallombardo  1 , Giuseppina Lo Balbo  1 , Giuseppe Cucinella  1 , Giulio Sozzi  1 , Vito Andrea Capozzi  3 , Antonino Abbate  1 , Antonio Simone Laganà  1   4 , Simone Garzon  5 , Vito Chiantera  1   4
Affiliations
Review

Conventional Laparoscopy versus Robotic-Assisted Aortic Lymph-Nodal Staging for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Mariano Catello Di Donna et al. J Clin Med. .

Abstract

Aortic lymph node metastases are a relative common finding in locally advanced cervical cancer. Minimally invasive surgery is the preferred approach to perform para-aortic lymph nodal staging to reduce complications, hospital stay, and the time to primary treatment. This meta-analysis (CRD42022335095) aimed to compare the surgical outcomes of the two most advanced approaches for the aortic staging procedure: conventional laparoscopy (CL) versus robotic-assisted laparoscopy (RAL). The meta-analysis was conducted according to the PRISMA guideline. The search string included the following keywords: "Laparoscopy" (MeSH Unique ID: D010535), "Robotic Surgical Procedures" (MeSH Unique ID: D065287), "Lymph Node Excision" (MeSH Unique ID: D008197) and "Aorta" (MeSH Unique ID: D001011), and "Uterine Cervical Neoplasms" (MeSH Unique ID: D002583). A total of 1324 patients were included in the analysis. Overall, 1200 patients were included in the CL group and 124 patients in the RAL group. Estimated blood loss was significantly higher in CL compared with RAL (p = 0.02), whereas hospital stay was longer in RAL compared with CL (p = 0.02). We did not find significant difference for all the other parameters, including operative time, intra- and postoperative complication rate, and number of lymph nodes excised. Based on our data analysis, both CL and RAL are valid options for para-aortic staging lymphadenectomy in locally advanced cervical cancer.

Keywords: conventional laparoscopy; gynecological oncology; locally advanced cervical cancer; robotic-assisted laparoscopy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow-chart of study selection and inclusion.
Figure 2
Figure 2
Intraoperative complications in the (a) laparoscopic group (I2 = 47.7%; pooled proportion = 1.5%) and (b) robotic group (I2 = 0%; pooled proportion = 4.1%).
Figure 3
Figure 3
Postoperative complications in the (a) laparoscopic group (I2 = 43.9%; pooled proportion = 7.7%) and (b) robotic group (I2 = 0%; pooled proportion = 11.1%).
Figure 4
Figure 4
Conversion from minimally invasive to open surgery (laparotomy) in the (a) laparoscopic group (I2 = 38.4%; pooled proportion = 1.2%) and (b) robotic group (I2 = 0%; pooled proportion = 2.2%).
See this image and copyright information in PMC

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