| ObjectiveThis study assessed the efficacy and safety of da Vinci robotic surgery for the treatment of stage Ⅱ-Ⅲ gastric cancer through a meta-analysis of clinical comparison studies between da Vinci robotic surgery and laparoscopic surgery for the treatment of stage Ⅱ-Ⅲ gastric cancer.MethodsComputer searches of several domestic and international databases such as digital journal full-text database(Wanfang),Chinese journal full-text database(Zhiwang),Vipers,Web of science,,Embase,Pub Med,Cochrane and other databases were conducted to collect publicly available studies from January 2016 to December 2021 Robotic gastrectomy(RG)versus laparoscopic radical gastrectomy(LG)The literature compares the clinical outcomes of robotic gastrectomy(RG)and laparoscopic gastrectomy(LG).Chinese and English literature on the safety and efficacy of robotic gastrectomy and laparoscopic gastrectomy for gastric cancer The literature was reviewed according to inclusion and exclusion criteria,and relevant data for stage Ⅱ-Ⅲ gastric cancer were extracted for meta-analysis.Data on operative time,number of lymph nodes cleared,intraoperative bleeding,postoperative compli-cations such as pancreatic complications,delayed gastric emptying,anastomotic leak,reoperation rate and mortality were compared between the two groups.The data obtained were processed using RevMan 5.3 software and analysed according to the heterogeneity of the data by selecting either a random-effects model or a fixed-effects model.The 95%confidence interval(95% CI)and weighted mean difference(WMD)were used as the combined statistics for the measures,and the ratio 95% CI and(OR)were used for the dichotomous data.The magnitude of heterogeneity was assessed using I~2.ResultsA total of 14 publications were included in this study,and a total of 5693 patients with gastric cancer were included,including 1914 in the robotic surgery group and3779 in the laparoscopic surgery group.The results of the meta-analysis suggested that the surgery took longer in the robotic group compared to the laparoscopic group(WMD=42.68 min,95% CI [31.94.53.43],p<0.05),but compared to the laparoscopic group In the laparoscopic group,intraoperative blood loss was lower(WMD=-20.20,95% CI[-31.46.-8.94],p<0.05),the number of lymph nodes cleared was higher in the robotic group(WMD=2.24,95% CI[0.79,3.68],p<0.05),postoperative gastroint-estinal recovery was faster,and the time to first venting was less(WMD=-0.22,95%CI [-0.38,-0.06],P<0.05),younger patient age(WMD=-2.27,95% CI [-4.04-0.51],P=0.01),no significant differences in time to first postoperative meal,Number of postoperative,days in the hospital,incidence of postoperative complications,complications in the pancreas,anastomotic leakage,and delayed gastric drainage.,mortality,transit open rate,body mass index differences(P>0.05).ConclusionIn terms of safety,technical feasibility and efficacy,da Vinci robotic radical gastric cancer surgery is safe and reliable,offering clinicians more options in their approach to gastric cancer surgery. |
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