Robotic Versus Laparoscopic Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis

BackgroundRobotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP) are the two principal minimally invasive surgical approaches for patients with pancreatic body and tail adenocarcinoma. The use of RDP and LDP for pancreatic ductal adenocarcinoma (PDAC) remains controversial, and which one can provide a better R0 rate is not clear.MethodsA comprehensive search for studies that compared robotic versus laparoscopic distal pancreatectomy for PDAC published until July 31, 2021, was conducted. Data on perioperative outcomes and oncologic outcomes (R0-resection and lymph node dissection) were subjected to meta-analysis. PubMed, Cochrane Central Register, Web of Science, and EMBASE were searched based on a defined search strategy to identify eligible studies before July 2021.ResultsSix retrospective studies comprising 572 patients (152 and 420 patients underwent RDP and LDP) were included. The present meta-analysis showed that there were no significant differences in operative time, tumor size, and lymph node dissection between RDP and LDP group. Nevertheless, compared with the LDP group, RDP results seem to demonstrate a possibility in higher R0 resection rate (p<0.0001).ConclusionsThis systematic review and meta-analysis suggest that RDP is a technically and oncologically safe and feasible approach for selected PDAC patients. Large randomized and controlled prospective studies are needed to confirm this data.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier [CRD42021269353].

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Role of lateral pelvic lymph node dissection in rectal cancer: A systematic review and meta-analysis

Indian Journal of Colo-Rectal Surgery ◽

10.4103/ijcs.ijcs_30_20 ◽

2020 ◽

Vol 3 (2) ◽

pp. 41

Author(s):

Ashwin Rajendiran ◽

Sachin Shenoy ◽

Ahmed Shalaby ◽

YKS Viswanath ◽

Venkatesh Shanmugam

Keyword(s):

Systematic Review ◽

Rectal Cancer ◽

Lymph Node ◽

Lymph Node Dissection ◽

Meta Analysis ◽

Pelvic Lymph Node Dissection ◽

Pelvic Lymph Node ◽

Node Dissection ◽

Lateral Pelvic Lymph Node

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Is lymph node dissection necessary for resectable intrahepatic cholangiocarcinoma? A systematic review and meta-analysis

HPB ◽

10.1016/j.hpb.2018.12.011 ◽

2019 ◽

Vol 21 (7) ◽

pp. 784-792 ◽

Cited By ~ 9

Author(s):

Rui Zhou ◽

Dihan Lu ◽

Wenda Li ◽

Wenliang Tan ◽

Sicong Zhu ◽

...

Keyword(s):

Systematic Review ◽

Lymph Node ◽

Lymph Node Dissection ◽

Intrahepatic Cholangiocarcinoma ◽

Meta Analysis ◽

Node Dissection

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Laparoscopic Pancreaticoduodenectomy Versus Conventional Open Approach for Patients With Pancreatic Duct Adenocarcinoma: An Up-to-Date Systematic Review and Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.749140 ◽

2021 ◽

Vol 11 ◽

Author(s):

Qingbo Feng ◽

Wenwei Liao ◽

Zechang Xin ◽

Hongyu Jin ◽

Jinpeng Du ◽

...

Keyword(s):

Systematic Review ◽

Overall Survival ◽

Lymph Node ◽

Blood Loss ◽

Survival Time ◽

Pancreatic Duct ◽

Meta Analysis ◽

R0 Resection ◽

Node Dissection ◽

Pancreatic Duct Adenocarcinoma

BackgroundTo compare perioperative and oncological outcomes of pancreatic duct adenocarcinoma (PDAC) after laparoscopic versus open pancreaticoduodenectomy (LPD vs. OPD), we performed a meta-analysis of currently available propensity score matching studies and large-scale retrospective cohorts to compare the safety and overall effect of LPD to OPD for patients with PDAC.MethodsA meta-analysis was registered at PROSPERO and the registration number is CRD42021250395. PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched based on a defined search strategy to identify eligible studies before March 2021. Data on operative times, blood loss, 30-day mortality, reoperation, length of hospital stay (LOS), overall morbidity, Clavien–Dindo ≥3 complications, postoperative pancreatic fistula (POPF), blood transfusion, delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), and oncologic outcomes (R0 resection, lymph node dissection, overall survival, and long-term survival) were subjected to meta-analysis.ResultsOverall, we identified 10 retrospective studies enrolling a total of 11,535 patients (1,514 and 10,021 patients underwent LPD and OPD, respectively). The present meta-analysis showed that there were no significant differences in overall survival time, 1-year survival, 2-year survival, 30-day mortality, Clavien-Dindo ≥3 complications, POPF, DGE, PPH, and lymph node dissection between the LPD and OPD groups. Nevertheless, compared with the OPD group, LPD resulted in significantly higher rate of R0 resection (OR: 1.22; 95% CI 1.06–1.40; p = 0.005), longer operative time (WMD: 60.01 min; 95% CI 23.23–96.79; p = 0.001), lower Clavien–Dindo grade ≥III rate (p = 0.02), less blood loss (WMD: −96.49 ml; 95% CI −165.14 to −27.83; p = 0.006), lower overall morbidity rate (OR: 0.65; 95% CI 0.50 to 0.85; p = 0.002), shorter LOS (MD = −2.73; 95% CI −4.44 to −1.03; p = 0.002), higher 4-year survival time (p = 0.04), 5-year survival time (p = 0.001), and earlier time to starting adjuvant chemotherapy after surgery (OR: −10.86; 95% CI −19.42 to −2.30; p = 0.01).ConclusionsLPD is a safe and feasible alternative to OPD for patients with PDAC, and compared with OPD, LPD seemed to provide a similar OS.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails.

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