Robotic versus laparoscopic liver resection for posterosuperior segments: a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Minimally invasive hepatectomy for difficult lesions located in posterosuperior segments (segments I, IVa, VII and VIII) remains challenging. The value of robotic liver resection (RLR) compared with laparoscopic liver resection (LLR) for posterosuperior segments is controversial. Therefore, we performed this meta-analysis to validate the safety and efficacy of RLR in posterosuperior segments. METHODS: The Medline, Embase, Web of Science, and Cochrane Library electronic databases were searched to identify available research published up to October 2023. Statistical analysis was performed with RevMan software version 5.3. RESULTS: Six studies with a total of 2289 patients (RLR n = 749; LLR n = 1540) were included in this meta-analysis. The RLR group had less intraoperative blood loss (WMD = -119.54 ml, 95% CI -178.89 to -60.19, P < 0.0001), fewer blood transfusions (OR = 0.56, 95% CI 0.39 to 0.80, P = 0.001), a lower conversion rate (OR = 0.37, 95% CI 0.23 to 0.61, P < 0.0001), and a shorter operative time (WMD = -27.16 min, 95% CI -35.95 to -18.36, P < 0.00001). DISCUSSION: Compared with LLR, RLR for lesions in the posterosuperior segments could be safe and effective, and it has superior surgical outcomes.