A meta-analysis of the efficacy and safety of robotic surgery versus open surgery in the treatment of hilar cholangiocarcinoma / 中华肝胆外科杂志

ABSTRACT

Objective:To compare the efficacy and safety of robotic surgery and open surgery in the treatment of hilar cholangiocarcinoma.Methods:PubMed, Embase, Cochrane Library, Web of Science, CNKI and Wanfang database were searched to compare the treatment of hilar cholangiocarcinoma by robotic surgery and traditional open surgery. Literatures were searched from the establishment of the database to July 2023. Compare operation time, intraoperative blood transfusion rate, R 0 resection rate, lymph node metastasis rate, postoperative complication rate and hospital stays between the two groups. The combined odds ratio ( OR) and mean difference ( MD) and 95% confidence interval (95% CI) were calculated using RevMan 5.4 software. Results:A total of 4 studies were included, including 267 patients with hilar cholangiocarcinoma. There were 177 males and 90 females, aged (58.8±5.7) years. A total of 267 patients were divided into open surgery group ( n=165) and robotic surgery group ( n=102) according to the surgical formula. The extract results show operative time ( MD=-103.96, 95% CI -216.90-8.98, P=0.070) and intraoperative blood transfusion rate ( OR=1.32, 95% CI 0.43-4.07, P=0.630), R 0 resection rate ( OR=1.41, 95% CI 0.71-2.81, P=0.330), lymph node metastasis rate ( OR=1.62, 95% CI 0.46-5.63, P=0.450), postoperative complications ( OR=0.60, 95% CI 0.28-1.31, P=0.200), and postoperative hospital stay ( MD=2.17, 95% CI -11.56-15.90, P=0.760). Conclusion:In the treatment of hilar cholangiocarcinoma, robotic surgery is as safe and feasible as open surgery. However, due to the limited number and quality of included studies, the above conclusions need to be verified by more high-quality studies.