Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review
<i>Background and Objectives</i>: Gastrectomy with D2 lymphadenectomy is the standard surgical treatment with curative intent for patients with gastric cancer (GC). Over the last three decades, surgeons have been increasingly adopting laparoscopic surgery for GC, due to its better short-...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-06-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/6/834 |
| _version_ | 1797484559036579840 |
|---|---|
| author | Maurizio Zizzo Magda Zanelli Francesca Sanguedolce Federica Torricelli Andrea Morini David Tumiati Federica Mereu Antonia Lavinia Zuliani Andrea Palicelli Stefano Ascani Alessandro Giunta |
| author_facet | Maurizio Zizzo Magda Zanelli Francesca Sanguedolce Federica Torricelli Andrea Morini David Tumiati Federica Mereu Antonia Lavinia Zuliani Andrea Palicelli Stefano Ascani Alessandro Giunta |
| author_sort | Maurizio Zizzo |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Gastrectomy with D2 lymphadenectomy is the standard surgical treatment with curative intent for patients with gastric cancer (GC). Over the last three decades, surgeons have been increasingly adopting laparoscopic surgery for GC, due to its better short-term outcomes. In particular, laparoscopic gastrectomy (LG) has been routinely used for early gastric cancer (EGC) treatment. However, LG suffers from technical limitations and drawbacks, such as a two-dimensional surgical field of view, limited movement of laparoscopic tools, unavoidable physiological tremors and discomfort for operating surgeon. Therefore, robotic surgery has been developed to address such limitations. <i>Materials and Methods</i>: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines in order to investigate the benefits and harms of robotic gastrectomy (RG) compared to the LG. PubMed/MEDLINE, Scopus, Cochrane Library (Cochrane Database of Systematic Re-views, Cochrane Central Register of Controlled Trials-CENTRAL) and Web of Science (Science and Social Science Citation Index) databases were used to search all related literature. <i>Results</i>: The 7 included meta-analyses covered an approximately 20 years-study period (2000–2020). Almost all studies included in the meta-analyses were retrospective ones and originated from Asian countries (China and Korea, in particular). Examined overall population ranged from 3176 to 17,712 patients. If compared to LG, RG showed both operative advantages (operative time, estimated blood loss, number of retrieved lymph nodes) and perioperative ones (time to first flatus, time to restart oral intake, length of hospitalization, overall complications, Clavien-Dindo (CD) ≥ III complications, pancreatic complications), in the absence of clear differences of oncological outcomes. However, costs of robotic approach appear significant. <i>Conclusions</i>: It is impossible to make strong recommendations, due to the statistical weakness of the included studies. Further randomized, possibly multicenter trials are strongly recommended, if we want to have our results confirmed. |
| first_indexed | 2024-03-09T23:06:05Z |
| format | Article |
| id | doaj.art-a0b9a53831914c2487c073956c8bd9f3 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T23:06:05Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-a0b9a53831914c2487c073956c8bd9f32023-11-23T17:53:21ZengMDPI AGMedicina1010-660X1648-91442022-06-0158683410.3390/medicina58060834Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic ReviewMaurizio Zizzo0Magda Zanelli1Francesca Sanguedolce2Federica Torricelli3Andrea Morini4David Tumiati5Federica Mereu6Antonia Lavinia Zuliani7Andrea Palicelli8Stefano Ascani9Alessandro Giunta10Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyPathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyPathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, 71122 Foggia, ItalyLaboratory of Translational Research, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalySurgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalySurgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalySurgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalySurgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyPathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, ItalyHematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, 06129 Perugia, ItalySurgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy<i>Background and Objectives</i>: Gastrectomy with D2 lymphadenectomy is the standard surgical treatment with curative intent for patients with gastric cancer (GC). Over the last three decades, surgeons have been increasingly adopting laparoscopic surgery for GC, due to its better short-term outcomes. In particular, laparoscopic gastrectomy (LG) has been routinely used for early gastric cancer (EGC) treatment. However, LG suffers from technical limitations and drawbacks, such as a two-dimensional surgical field of view, limited movement of laparoscopic tools, unavoidable physiological tremors and discomfort for operating surgeon. Therefore, robotic surgery has been developed to address such limitations. <i>Materials and Methods</i>: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines in order to investigate the benefits and harms of robotic gastrectomy (RG) compared to the LG. PubMed/MEDLINE, Scopus, Cochrane Library (Cochrane Database of Systematic Re-views, Cochrane Central Register of Controlled Trials-CENTRAL) and Web of Science (Science and Social Science Citation Index) databases were used to search all related literature. <i>Results</i>: The 7 included meta-analyses covered an approximately 20 years-study period (2000–2020). Almost all studies included in the meta-analyses were retrospective ones and originated from Asian countries (China and Korea, in particular). Examined overall population ranged from 3176 to 17,712 patients. If compared to LG, RG showed both operative advantages (operative time, estimated blood loss, number of retrieved lymph nodes) and perioperative ones (time to first flatus, time to restart oral intake, length of hospitalization, overall complications, Clavien-Dindo (CD) ≥ III complications, pancreatic complications), in the absence of clear differences of oncological outcomes. However, costs of robotic approach appear significant. <i>Conclusions</i>: It is impossible to make strong recommendations, due to the statistical weakness of the included studies. Further randomized, possibly multicenter trials are strongly recommended, if we want to have our results confirmed.https://www.mdpi.com/1648-9144/58/6/834gastric cancergastrectomyroboticlaparoscopicsurgeryoutcome |
| spellingShingle | Maurizio Zizzo Magda Zanelli Francesca Sanguedolce Federica Torricelli Andrea Morini David Tumiati Federica Mereu Antonia Lavinia Zuliani Andrea Palicelli Stefano Ascani Alessandro Giunta Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review Medicina gastric cancer gastrectomy robotic laparoscopic surgery outcome |
| title | Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review |
| title_full | Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review |
| title_fullStr | Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review |
| title_full_unstemmed | Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review |
| title_short | Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review |
| title_sort | robotic versus laparoscopic gastrectomy for gastric cancer an updated systematic review |
| topic | gastric cancer gastrectomy robotic laparoscopic surgery outcome |
| url | https://www.mdpi.com/1648-9144/58/6/834 |
| work_keys_str_mv | AT mauriziozizzo roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT magdazanelli roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT francescasanguedolce roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT federicatorricelli roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT andreamorini roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT davidtumiati roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT federicamereu roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT antonialaviniazuliani roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT andreapalicelli roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT stefanoascani roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview AT alessandrogiunta roboticversuslaparoscopicgastrectomyforgastriccanceranupdatedsystematicreview |