title: Robotic versus Laparoscopic Distal Pancreatectomy: A Meta-Analysis of Short-Term Outcomes.
abstract: OBJECTIVE
  To compare the safety and efficacy of robotic-assisted distal pancreatectomy (RADP) and laparoscopic distal pancreatectomy (LDP).
  
  
  METHODS
  A literature search of PubMed, EMBASE, and the Cochrane Library database up to June 30, 2015 was performed. The following key words were used: pancreas, distal pancreatectomy, pancreatic, laparoscopic, laparoscopy, robotic, and robotic-assisted. Fixed and random effects models were applied. Study quality was assessed using the Newcastle-Ottawa Scale.
  
  
  RESULTS
  Seven non-randomized controlled trials involving 568 patients met the inclusion criteria. Compared with LDP, RADP was associated with longer operating time, lower estimated blood loss, a higher spleen-preservation rate, and shorter hospital stay. There was no significant difference in transfusion, conversion to open surgery, R0 resection rate, lymph nodes harvested, overall complications, severe complications, pancreatic fistula, severe pancreatic fistula, ICU stay, total cost, and 30-day mortality between the two groups.
  
  
  CONCLUSIONS
  RADP is a safe and feasible alternative to LDP with regard to short-term outcomes. Further studies on the long-term outcomes of these surgical techniques are required.
  To date, there is no consensus on whether laparoscopic or robotic-assisted distal pancreatectomy is more beneficial to the patient. This is the first meta-analysis to compare laparoscopic and robotic-assisted distal pancreatectomy. We found that robotic-assisted distal pancreatectomy was associated with longer operating time, lower estimated blood loss, a higher spleen-preservation rate, and shorter hospital stay. There was no significant difference in transfusion, conversion to open surgery, overall complications, severe complications, pancreatic fistula, severe pancreatic fistula, ICU stay, total cost, and 30-day mortality between the two groups.
authors.affiliation: Department of General Surgery, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Zhou
authors.affiliation: Department Of Hepatobiliary Surgery, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo 315040, Zhejiang Province, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Xin
authors.affiliation: Department of Gastroenterology & Pancreatic Surgery, Zhejiang Provincial People Hospital, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Mou
authors.affiliation: Department of Gastroenterology & Pancreatic Surgery, Zhejiang Provincial People Hospital, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Xiao-Wu
authors.initials: XW
authors.lastname: Xu
authors.affiliation: Department of General Surgery, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Miao-Zun
authors.initials: MZ
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology & Pancreatic Surgery, Zhejiang Provincial People Hospital, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of General Surgery, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China.
authors.forename: Rong-Gao
authors.initials: RG
authors.lastname: Chen
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*