Short-Term Outcomes After Robotic Versus Open Liver Resection: A Systematic Review and Meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized cohort studies (13 retrospective, 1 prospective).
PubMed 35199298 · doi:10.1007/s12029-022-00810-6
What was done
A systematic review and meta-analysis searched MEDLINE, Scopus, Google Scholar, Cochrane, and Clinicaltrials.gov for studies published between January 2000 and January 2022. It included 14 non-randomized comparative studies (13 retrospective, 1 prospective) comparing robotic liver resection (RLR; n = 640) with open liver resection (OLR; n = 1,161) in a total of 1,801 patients.
What was found
RLR was associated with significantly lower overall morbidity (p < 0.001), shorter length of hospital stay (p = 0.002), and less intraoperative blood loss (p < 0.001). Operative time was significantly longer in the RLR group (p < 0.001). Blood transfusion requirements, R0 resection margins, and mortality rates showed no significant differences between groups. The cumulative conversion rate for RLR was 5%. Effect sizes, odds ratios, and confidence intervals were not reported in the abstract.
Why it matters
This meta-analysis summarizes perioperative outcomes for robotic liver resections, indicating safety and recovery advantages over open approaches despite increased operative duration.
Limits
All included studies were non-randomized and almost entirely retrospective, presenting a high risk of confounding by indication and surgeon selection bias. Specific numerical effect sizes (mean differences, odds ratios) and long-term oncologic outcomes were not reported in the abstract.
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