Clinical effect of robotic versus laparoscopic splenectomy in treatment of nontraumatic splenic diseases:A Meta-analysis

Objective To investigate the clinical effect and safety of robotic versus laparoscopic splenectomy in the treatment of nontraumatic splenic diseases. Methods According to the inclusion and exclusion criteria,PubMed,Web of Science,Embase,Cochrane Library,CBM,CNKI,Wanfang Data,and VIP were systematically searched for Chinese and English articles on the comparison of robotic splenectomy and laparoscopic splenectomy in the treatment of nontraumatic splenic diseases published up to March 2019. After quality assessment was performed for the articles included,RevMan 5. 0 provided by Cochrane Library was used for analysis. Mean difference(MD) and rate difference(RD) were used as the effect indicators for continuous variables and binary variables,and pooled value and 95% confidence interval(CI) were calculated. Results A total of 7 studies with 374 patients were included,with 160 patients in the robotic splenectomy group and214 in the laparoscopic splenectomy group. The results of the meta-analysis showed that compared with laparoscopic splenectomy,robotic splenectomy had significantly lower intraoperative blood loss(MD =-127. 14,95% CI:-199. 87 to 54. 42,P < 0. 01),rate of conversion to laparotomy(RD =-0. 06,95% CI:-0. 11 to 0. 01,P = 0. 02),and rate of postoperative complications(RD =-0. 10,95% CI:-0.20 to 0. 01,P = 0. 04). There were no significant differences in time of operation and length of hospital stay between the two surgical procedures(both P > 0. 05). Conclusion Based on current evidence,robotic splenectomy has better clinical effect and safety than laparoscopic splenectomy in some aspects in the treatment of nontraumatic splenic diseases,and more multicenter large-sample randomized controlled trials are needed in the future for verification.