Comparison Of Clinical Outcomes Among Robotic And Laparoscopic For Gastric Cancer,A Systematic Review

Objective: To evaluated the short-term and long-term efficacy and safety of Robot gastrectomy and Laparoscopic gastrectomy by using a systematic review of all the published researches.Methods: Searched the literature at The Cochrane Library,Pub Med,EMBASE,Web of Science,CBMdisc,CNKI,VIP and wanfang databases from January 2003 to January 2018,published Languages are English and Chinese.All the statistical tests were performed by Review Manger 5.3 and Stata 12.1 after evaluated the quality of studies.The endpoint is the Operative time,Evaluated Blood Loss(EBL),lymph nodes harvested,Time of First Flatus,time of First fluid intake,the postoperative hospital stay and Total cost.Results: A total of 17 literatures were finally included,including 16 retrospective studies and 1 randomized controlled study.A total of 4536 patients with gastric cancer were included,2966 patients in the Laparoscopic group and 1570 patients in the robot group.Robotic surgery improved the EBL(WMD=19.84,95%CI[4.02,35.66],P<0.1),Number of harvested lymph nodes(WMD=-3.05,95%CI[-4.45,-1.64],P<0.1),Length of postoperative hospital stay(WMD=0.92,95%CI[0.52,1.31],P<0.1),compared with Laparoscopic group.Days of First Flatus,Days of eating liquid diets,death rate and 3year OS have no significant difference between the two groups Conclusions: the Robotic gastrectomy for gastric cancer is more safe than the Laparoscopic,gastrectomy,but longer operation time and higher hospitalization costs are also factors limiting its large-scale operation.