Comparison of robotic vs laparoscopic vs open distal pancreatectomy. A systematic review and network meta-analysis.

Gavriilidis, Paschalis, Roberts, Keith J and Sutcliffe, Robert P (2019) Comparison of robotic vs laparoscopic vs open distal pancreatectomy. A systematic review and network meta-analysis. HPB : the official journal of the International Hepato Pancreato Biliary Association, 21 (10). pp. 1268-1276. ISSN 1477-2574. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://www.hpbonline.org/article/S1365-182X(19)30...

Abstract

INTRODUCTION

The current evidence comparing oncological adequacy and effectiveness of robotic and laparoscopic distal pancreatectomy to open distal pancreatectomy for pancreatic adenocarcinoma is inconclusive. Recent pairwise meta-analyses demonstrated reduced blood loss and length of stay as the principal advantages of RDP and LDP compared to ODP. The aim of this study was to compare the three approaches to distal pancreatectomy conducting a pairwise meta-analysis and consequently network meta-analysis.

METHODS

A systematic literature search was performed using the databases, EMBASE, Pubmed, the Cochrane library, and Google Scholar. Meta-analyses were performed using both fixed-effect and random-effect models.

RESULTS

RDP cohort represented only 11% of the total sample; significantly younger patients with smaller size tumours were included in the RDP and LDP cohorts compared to ODP cohort. Significantly less blood loss and shorter length of stay were the advantages of both RDP and LDP compared to ODP. The ODP cohort included significantly more specimens with positive resection margins compared to RDP and LDP cohorts.

DISCUSSION

The results of the present study demonstrate that reduced blood losses and shorter length of stay are the advantages of RDP and LDP compared to ODP. However, demographic discrepancies, underpowered RDP sample and differences in oncological burden do not permit certain conclusions regarding the oncological safety of RDP and LDP for pancreatic adenocarcinoma.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
WO Surgery
Divisions: Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Gareth Sunley
Date Deposited: 17 Jul 2020 14:52
Last Modified: 17 Jul 2020 14:52
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3281

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