Comparison Of Efficacy Of Robotic-assisted Surgery And Conventional Laparoscopy In The Treatment Of Ovarian Cancer:A Meta-analysis

Objective: To compare the clinical effect and safety of robotic-assisted surgery(RAS)and conventional laparoscopy(CL)in ovarian cancer treatment.Methods: By searching Pub Med,eambase,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,China Biology Medicine disc(CBM)and Vip,time limit set from set up the to December 2021,in Chinese and English languages,and managed with the software Noteexpress.A meta-analysis was performed using Review Manager 5.4,and the mean difference(MD)value,95% confidence interval(CI)and odds ratio(OR)were selected as the effect size for continuous and dichotomous data types.Results: Thirteen literatures were finally screened according to the inclusion and exclusion criteria,including seven literatures in Chinese,six in English,and 13 were all retrospective case-control studies.A total of 841 patients with ovarian cancer were involved,311 in the RAS and 530 in the CL group.The included literatures showed no statistical difference for patients’ body mass index,age and other general clinical data.Meta analysis contrasting results showed that: the RAS experienced less blood loss than the CL(MD=-19.13 ml,95%CI[-24.02,-14.24],p<0.00001);higher number of lymph node resections(MD=2.49,95%CI[0.95,4.04],p=0.002);less the lenthg of day(MD=-0.95 day,95%CI[-1.68,-0.23],p=0.01).Operative time(MD=19.11 min,95%CI[-6.46,44.68],p=0.14),Intraoperative complication rates(OR=0.91,95%CI[0.33,2.49],p=0.85),blood transfusion rate(OR=0.53,95%CI[0.24,1.17],P=0.11),postoperative complication(OR=0.75,95%CI[0.46,1.23],p=0.25),gastrointestinal recovery time(MD=-0.08 min,95%CI[-0.17,0.01],P=0.07)and disease-free survival(MD=1.81,95%CI[0.66,5.00],p=0.25)were not different.Conclusion:1.The number of lymph node resections,blood loss and length of the lenthg of day in the robotic-assisted surgery were significantly better than those in the conventional laparoscopy2.There was no significant difference in operation time,intraoperative complication rates,blood transfusion rate,postoperative complications and gastrointestinal recovery time between robotic-assisted surgery and conventional laparoscopy.3.On the premise of improving preoperative preparation and strictly mastering surgical indications,robotic surgery system is safe and feasible for the surgical treatment of ovarian cancer.