title: Robotic versus open gastrectomy for gastric cancer: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of robotic gastrectomy versus open gastrectomy for gastric cancer.
  
  
  METHODS
  A comprehensive search of PubMed, EMBASE, Cochrane Library, and Web of Knowledge was performed. Systematic review was carried out to identify studies comparing robotic gastrectomy and open gastrectomy in gastric cancer. Intraoperative and postoperative outcomes were also analyzed to evaluate the safety and efficacy of the surgery. A fixed effects model or a random effects model was utilized according to the heterogeneity.
  
  
  RESULTS
  Four studies involving 5780 patients with 520 (9.00%) cases of robotic gastrectomy and 5260 (91.00%) cases of open gastrectomy were included in this meta-analysis. Compared to open gastrectomy, robotic gastrectomy has a significantly longer operation time (weighted mean differences (WMD) =92.37, 95% confidence interval (CI): 55.63 to 129.12, P<0.00001), lower blood loss (WMD: -126.08, 95% CI: -189.02 to -63.13, P<0.0001), and shorter hospital stay (WMD = -2.87; 95% CI: -4.17 to -1.56; P<0.0001). No statistical difference was noted based on the rate of overall postoperative complication, wound infection, bleeding, number of harvested lymph nodes, anastomotic leakage and postoperative mortality rate.
  
  
  CONCLUSIONS
  The results of this meta-analysis suggest that robotic gastrectomy is a better alternative technique to open gastrectomy for gastric cancer. However, more prospective, well-designed, multicenter, randomized controlled trials are necessary to further evaluate the safety and efficacy as well as the long-term outcome.
authors: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, P.R. China.
authors: Guixiang
authors: G
authors: Liao
authors: Jiarong
authors: J
authors: Chen
authors: Chen
authors: C
authors: Ren
authors: Rong
authors: R
authors: Li
authors: Shasha
authors: S
authors: Du
authors: Guozhu
authors: G
authors: Xie
authors: Haijun
authors: H
authors: Deng
authors: Kaijun
authors: K
authors: Yang
authors: Yawei
authors: Y
authors: Yuan
mesh_terms: D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D011183:Postoperative Complications / Q000209:etiology; D012371:Robotics / Q000379:methods*; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors