Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis
Purpose: Minimally-invasive total gastrectomy (MITG) is associated with lower morbidity in comparison to open total gastrectomy but requires a learning curve (LC). We aimed to perform a pooled analysis of the number of cases required to surmount the LC (NLC) in MITG. Methods: A systematic review of...
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| Format: | Journal Article |
| Language: | English |
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2024
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| Online Access: | https://hdl.handle.net/10356/172944 |
| _version_ | 1811691541740126208 |
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| author | Chan, Kai Siang Oo, Aung Myint |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Chan, Kai Siang Oo, Aung Myint |
| author_sort | Chan, Kai Siang |
| collection | NTU |
| description | Purpose: Minimally-invasive total gastrectomy (MITG) is associated with lower morbidity in comparison to open total gastrectomy but requires a learning curve (LC). We aimed to perform a pooled analysis of the number of cases required to surmount the LC (NLC) in MITG. Methods: A systematic review of PubMed, Embase, Scopus and the Cochrane Library from inception until August 2022 was performed for studies reporting the LC in laparoscopic total gastrectomy (LTG) and/or robotic total gastrectomy (RTG). Poisson mean (95% confidence interval [CI]) was used to determine the NLC. Negative binomial regression was performed as a comparative analysis. Results: There were 12 articles with 18 data sets: 12 data sets (n = 1202 patients) on LTG and 6 data sets (n = 318 patients) on RTG. The majority of studies were conducted in East Asia (94.4%). The majority of the data sets (n = 12/18, 66.7%) used non-arbitrary analyses. The NLC was significantly smaller in RTG in comparison to LTG [RTG 20.5 (95% CI 17.0–24.5); LTG 43.9 (95% CI 40.2–47.8); incidence rate ratio 0.47, p < 0.001]. The NLC was comparable between totally-laparoscopic total gastrectomy (TLTG) and laparoscopic-assisted total gastrectomy (LATG) [LATG 39.0 (95% CI 30.8–48.7); TLTG 36.0 (95% CI 30.4–42.4)]. Conclusions: The LC for RTG was significantly shorter for LTG. However existing studies are heterogeneous. |
| first_indexed | 2024-10-01T06:21:32Z |
| format | Journal Article |
| id | ntu-10356/172944 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T06:21:32Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | ntu-10356/1729442024-01-03T05:52:47Z Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis Chan, Kai Siang Oo, Aung Myint Lee Kong Chian School of Medicine (LKCMedicine) Tan Tock Seng Hospital Yong Loo Lin School of Medicine, NUS Science::Medicine Gastrectomy Gastric Cancer Purpose: Minimally-invasive total gastrectomy (MITG) is associated with lower morbidity in comparison to open total gastrectomy but requires a learning curve (LC). We aimed to perform a pooled analysis of the number of cases required to surmount the LC (NLC) in MITG. Methods: A systematic review of PubMed, Embase, Scopus and the Cochrane Library from inception until August 2022 was performed for studies reporting the LC in laparoscopic total gastrectomy (LTG) and/or robotic total gastrectomy (RTG). Poisson mean (95% confidence interval [CI]) was used to determine the NLC. Negative binomial regression was performed as a comparative analysis. Results: There were 12 articles with 18 data sets: 12 data sets (n = 1202 patients) on LTG and 6 data sets (n = 318 patients) on RTG. The majority of studies were conducted in East Asia (94.4%). The majority of the data sets (n = 12/18, 66.7%) used non-arbitrary analyses. The NLC was significantly smaller in RTG in comparison to LTG [RTG 20.5 (95% CI 17.0–24.5); LTG 43.9 (95% CI 40.2–47.8); incidence rate ratio 0.47, p < 0.001]. The NLC was comparable between totally-laparoscopic total gastrectomy (TLTG) and laparoscopic-assisted total gastrectomy (LATG) [LATG 39.0 (95% CI 30.8–48.7); TLTG 36.0 (95% CI 30.4–42.4)]. Conclusions: The LC for RTG was significantly shorter for LTG. However existing studies are heterogeneous. 2024-01-03T05:30:29Z 2024-01-03T05:30:29Z 2023 Journal Article Chan, K. S. & Oo, A. M. (2023). Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis. Surgery Today. https://dx.doi.org/10.1007/s00595-023-02672-2 0941-1291 https://hdl.handle.net/10356/172944 10.1007/s00595-023-02672-2 36912987 2-s2.0-85149921801 en Surgery Today © 2023 The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. All rights reserved. |
| spellingShingle | Science::Medicine Gastrectomy Gastric Cancer Chan, Kai Siang Oo, Aung Myint Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis |
| title | Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis |
| title_full | Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis |
| title_fullStr | Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis |
| title_full_unstemmed | Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis |
| title_short | Learning curve of laparoscopic and robotic total gastrectomy: a systematic review and meta-analysis |
| title_sort | learning curve of laparoscopic and robotic total gastrectomy a systematic review and meta analysis |
| topic | Science::Medicine Gastrectomy Gastric Cancer |
| url | https://hdl.handle.net/10356/172944 |
| work_keys_str_mv | AT chankaisiang learningcurveoflaparoscopicandrobotictotalgastrectomyasystematicreviewandmetaanalysis AT ooaungmyint learningcurveoflaparoscopicandrobotictotalgastrectomyasystematicreviewandmetaanalysis |