Comparison of early postoperative results between robot-assisted and laparoscopic splenectomy for non-traumatic splenic diseases rather than portal hypertensive hypersplenism-a meta-analysis

摘要

Laparoscopic splenectomy (LS) is considered as the gold standard in the surgical management of non-traumatic diseases of spleen (NDOS), and robotic splenectomy (RS) is a promising alternative treatment. This study aimed to compare the effectiveness and safety of RS versus LS for NDOS. Several databases were systematically searched for the literature that compared RS with LS for NDOS. Primary outcomes included operative time, blood loss, conversion to open, hospital stay, cost, postoperative complication, and postoperative morbidity. Study-specific effect sizes and their 95% confidence interval (CI) were combined to calculate the pooled value using a fixed-effects or random-effects model. Seven studies were included with 374 patients. Major blood loss (mean difference [MD] = -127.14; 95% CI = -199.87-54.42), conversion to open (rate difference [RD] = -0.06; 95% CI = -0.11-0.01), and postoperative complication (RD = -0.10; 95% CI = -0.20-0.01) were less in the RS group compared with the LS group. There were no differences found in operative time and hospital stay. In our meta-analysis, perioperative mortality was not observed in the RS group. Compared with the LS group, RS group showed comparable effectiveness and safety for the treatment of NDOS based on the current evidence.