Robot-assisted versus open hepatectomy for liver tumors: Systematic review and meta-analysis

Abstract

Background: This meta-analysis was conducted to evaluate the effectiveness and safety of robot-assisted hepatectomy (RAH) versus open hepatectomy (OH) for liver tumors (LT). Methods: A computer-based literature search was conducted to identify all randomized or nonrandomized controlled trials of RAH and OH in the treatment of LT from January 2000 to July 2022. Study-specific effect sizes and their 95% confidence intervals (CIs) were combined to calculate the pooled values, using a fixed-effects or random-effects model. Results: Eight studies were included, with a combined total of 1079 patients. Compared with the OH group, the RAH group was found to involve less blood loss (standardized mean difference [SMD] = −152.52 mL; 95% confidence interval [CI] = −266.85 to 38.18; p = 0.009), shorter hospital stay (SMD = −2.79; 95% CI = −4.19 to −1.40; p < 0.001), a lower rate of postoperative complications (odds ratio [OR] =0.67; 95% CI = 0.47–0.95; p = 0.02), and a lower recurrence rate (OR = 0.42; 95% CI = 0.23–0.77; p = 0.005). However, operative time was longer in the RAH group than in the OH group (SMD = 70.55; 95% CI = 37.58–103.53; p < 0.001). Conclusion: This systematic review shows that RAH is safe and feasible in the treatment of LT.