Comparison Of Short-term Clinical Outcomes Among Robotic And Laparoscopic And Open Gastrectomy For Gastric Cancer:A Systematic Review

Aim: To evaluate the short-term clinical outcomes and safety of Da Vinci robotic and laparoscopic and open gastrectomy for gastric cancer by performing a systematic review of the published studies.Methods: All published reviews of Da Vinci Robotic and Laparoscopic for gastric cancer were searched.We searched the databases included the Cochrane Library,PubMed,EMBASE,Web of Science,CNKI,VIP and Wanfang Database from 2000 to 2016.The endpoint was the Evaluated Blood Loss(EBL).Day of First Flatus,Days of eating liquid diets,Number of harvested lymph nodes,Length of postoperative hospital stay.Also,the amount of anastomotic leakage,ileus,wound infection were also performed.All calculations and statistical tests were performed using Revman5.3 and Stata12.0 software.Results: A total of 10255 patients with GC enrolled in 14 trials were divided into Da Vinci Robotic group(n = 1687).Laparoscopic group(n = 3283)and Open gastrectomy group(n = 5285).Da Vinci Robotic surgery improved the EBL[95%(CI):-21.97—-16.28],Days of First Flatus[95% CI:-0.37—-0.17],Number of harvested lymph nodes [95% CI: 1.03-2.31] and Length of postoperative hospital stay [95% CI:-0.8—-0.41] compared with Laparoscopic group.The incidence of f anastomotic leakage,anastomotic stenosis,anastomotic bleeding,ileus,wound infection between the two groups had no statistical difference.Da Vinci Robotic surgery improved the EBL[95%(CI):-89.72—-68.52],Days of First Flatus[95%(CI):-0.47—-0.22],Days of eating liquid diets[95%(CI):-1.35—-1.01] and Length of postoperative hospital stay[95%(CI):-1.60—-0.74] compared with open gastrectomy group.Conclusion: Da Vinci Robotic gastrectomy for gastric cancer is safer compared with Laparoscopic and Open gastrectomy,with the advantages of minimal invasion and postoperative recovery.