| Background Minimal invasive surgery is regarded as one of the things that change the human beings’ life. Today minimally invasive surgery has been widely used in many medical fields. Laparoscopic and endoscopic techniques have made great achievements. With the widely and deeply application, the shortage of the laparoscopic surgery gradually exposed. Under these circumstances, the robotic surgery arises. Robotic surgery is gradually popularly performed for many diseases, and it is widely applied in colic and rectal resection. Robotic liver resection has also made great progress in recent years. However, its safety and effectiveness in liver surgery is unclear. So the main aim of this study was to compare the safety and efficacy of Da Vinci robot assisted surgery and laparoscopic surgery in liver with respect to adult patients.Methods Literature searches of electronic databases (Medine、PubMed、Embase、 Science Citation Index、the Cochrane、ACP Journal Club and Chinese databases) were performed to identify studies that compared the clinical or oncologic outcomes of robotic liver resection (RLR) and lapaoscopic liver resection (LLR). This meta-analysis was performed using the Review Manager (RevMan) software (version 5.3) that is provided by the Cochrane Collaboration. The data used were mean differences and odds ratios or risk difference for continuous and dichotomous variables, respectively. Fixed-effects or random-effects models were adopted according to heterogeneity.Results Eight studies were identified for this meta-analysis. In total,235 patients underwent RLR, and 517 patients underwent LLR. The results revealed that the operative time was obviously longer in RLR group [MD 54.33,95%CI 5.18 to 103.48; P= 0.03], however the pathology of tumors, major complication rates[RD=-0.04 (95%CI:-0.08,0.00), P=0.04], largest tumor size were significantly favours for RLR compared with LLR. There were no significant differences in estimated blood losses (EBLs) [MD 66.34,95% CI-12.85 to 145.54; P= 0.1], conversion rates[OR=1.36 (95%CI:0.75,2.48), P=0.32], length of hospital stay[MD=-0.05(95%CI:-0.83,0.73), P=0.91],R0 negative resection rates[OR=0.57 (95%CI:0.31,1.06), P=0.08], total complication rates [RD=-0.05(95%CI:-0.09, 0.00), P=0.04] and 90-days mortality rates between the two techniques. Among all the complications, the occurrence of bleeding after operation was more frequently in LLR group [RD=-0.05 (95%CI:-0.09,0.00), P=0.04], while infection and biliary leakage rates were found no differences in two groups.Conclusions RLR is a promising technique and is a safe and effective alternative to LLR for hepatic surgery. The advantages of RLR include reducing the occurrence of major complication and so on, and it allows the surgeon to make more meticulous operation. Further studies are required to define the financial effects of RLR and the effects of RLR on long-term oncologic outcomes. |
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