title: Robot-assisted versus conventional laparoscopic surgery for endometrial cancer staging: A meta-analysis.
abstract: This meta-analysis broadly compared the safety and efficacy of robot-assisted laparoscopy (RAL) with that of conventional laparoscopy (CL) for endometrial cancer staging. The advantages of RAL were evaluated through the outcomes in terms of conversion rates, complications, length of operation, blood loss, number of lymph nodes harvested, and length of hospitalization. Three electronic databases (PubMed, MEDLINE, and EmBASE) were searched to identify eligible studies. We selected all retrospective studies documenting a comparison between RAL and CL for endometrial cancer staging between 2005 and 2015, and tallied with meta-analyses criteria. Only studies published in English were included in this analysis. The outcomes of the extracted data were pooled and estimated by the Review Manager version 5.1 software. Seventeen studies met the eligibility criteria. Among the 2105 patients reported, 912 underwent RAL and the other 1193 underwent CL for endometrial cancer staging. Compared with CL, RAL had lower conversion rates [risk ratio, 0.4; 95% confidence interval (CI), 0.25-0.64; p = 0.0002]. Its complications were also less than that of CL (risk ratio, 0.72; 95% CI, 0.56-0.94; p = 0.02). RAL was associated with significantly less intraoperative blood loss (weighted mean difference, -79.2 mL; 95% CI, from -103.43 to -54.97; p < 0.00001) and a shorter length of hospitalization (weighted mean difference, -0.37 days; 95% CI, from -0.57 to -0.17; p = 0.0003). We found no significant differences in the length of operation and number of lymph nodes harvested between the two groups. From our meta-analysis results, RAL is a safe and effective alternative to CL for endometrial cancer staging. Further studies are required to determine potential advantages or disadvantages of RAL.
authors: Department of Obstetrics and Gynaecology, Women Health Center of Shanxi, Children's Hospital of Shanxi, Taiyuan City, Shanxi Province, PR China. Electronic address: chsh-h@139.com.
authors: Shao-Hui
authors: SH
authors: Chen
authors: Department of Obstetrics and Gynaecology, Women Health Center of Shanxi, Children's Hospital of Shanxi, Taiyuan City, Shanxi Province, PR China.
authors: Zhao-Ai
authors: ZA
authors: Li
authors: Department of Obstetrics and Gynaecology, Women Health Center of Shanxi, Children's Hospital of Shanxi, Taiyuan City, Shanxi Province, PR China.
authors: Rui
authors: R
authors: Huang
authors: Department of Obstetrics and Gynaecology, Women Health Center of Shanxi, Children's Hospital of Shanxi, Taiyuan City, Shanxi Province, PR China.
authors: Hui-Qin
authors: HQ
authors: Xue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D016889:Endometrial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*
keywords: conventional laparoscopy; endometrial cancer; endometrial cancer staging; laparoscopy; robot assisted