Da Vinci Surgical System Versus Conventional Laparoscopic Surgery For Endometrial Cancer:A Meta-Analysis

Objective(s): The aim of this study was to compare the efficacy of the Da Vinci surgical system(DVSS)and conventional laparoscopic surgery(CLS)in treating endometrial carcinoma(EC),so as to provide a more effective treatment for clinical practice.Method(s): Utilizing the computer search term strategy,a thorough examination of CNKI,CBM,Wanfang,VIP,Pub Med,The Cochrane Library,Embase,Web of Science(WOS),and other databases was conducted.From the inception of each database to December 2022,a search period was conducted.Cohort studies were chosen to evaluate the effectiveness of da Vinci robots and traditional laparoscopic surgery systems in treating endometrial cancer.Screening out the relevant literature that meets the inclusion criteria of this article.The quality of the included cohort study were evaluated using the Newcastle-Ottawa Scale(NOS)literature quality evaluation form.Finally,the Rev Man 5.4 software provided by the Cochrane Collaboration was used to conduct a meta-analysis of the efficacy of the Da Vinci robot and the traditional laparoscopic surgery system in the treatment of endometrial cancer,including intraoperative blood loss,postoperative hospital stay,conversion rate,hospitalization costs,operation time,number of lymph nodes dissected,postoperative exhaust time,postoperative drainage tube removal time.Result(s): The retrieval technique employed yielded 13 articles,all of which were cohort studies,and a total of 1451 patients were included(711 in the DVSS group and 740 in the CLS group).The results of Meta-analysis showed that : Compared with CLS,DVSS can reduce intraoperative blood loss(MD=-46.64,95%CI=[-56.52,-36.77],P<0.00001),reduce postoperative hospital stay(MD =-1.50,95 % CI = [-1.76,-1.23 ],P < 0.00001),reduce the rate of conversion to laparotomy(RR = 0.27,95%CI = [ 0.07,0.96 ],P = 0.04),shorten the postoperative exhaust time(MD =-0.33,95%CI = [-0.64,-0.02 ],P = 0.04),shorten the postoperative drainage tube removal time(MD =-0.97,95%CI =[-1.58,-0.36 ],P = 0.002),but the hospitalization cost was higher than that of CLS group(MD = 0.91,95%CI = [ 0.32,1.51 ],P = 0.003).There were no statistically significant differences in operation time(MD = 0.22,95%CI=[-0.25,0.70 ],P = 0.36)and the number of lymph nodes dissected(MD =-1.97,95%CI = [-5.88,1.95 ],P = 0.32).Conclusion(s): In the operation of endometrial cancer,compared with CLS,DVSS has the advantages of less intraoperative blood loss,shorter postoperative hospital stay,lower conversion rate,shorter postoperative exhaust time and shorter postoperative drainage tube removal time.The current research results show that DVSS is safer and more effective than CLS in endometrial cancer surgery.