Abstract
Objective
to compare the safety and efficacy of robotic surgery and traditional open surgery in living donor liver hepatectomy.
Methods
This meta-analysis included 9 retrospective studies involving a total of 3379 patients, evaluating the primary and secondary outcomes of robotic surgery versus open surgery in donors and recipients. Binary variables were analyzed using odds ratios (ORs) and 95% confidence intervals (CIs), while continuous variables were analyzed using standardized mean differences (SMDs) and 95% CI.
Results
Robotic donor hepatectomy demonstrated significantly longer operative time (SMD = 1.26, 95% CI 0.75-1.76, I2 = 90.1%) and warm ischemia time (SMD = 2.24, 95% CI 0.94-3.53, I2 = 97.4%) compared to open surgery, both with moderate certainty. Conversely, no significant differences were observed in intraoperative blood loss (SMD = -0.61, 95% CI -1.29 to -0.07), postoperative hospital stay (SMD = -0.36, 95% CI -0.78 to 0.07), overall Clavien-Dindo grades 1-2 complications (OR = 0.68, 95% CI 0.40-1.15), grades 3-4 complications (OR = 1.33, 95% CI 0.44-3.99), or bile leakage incidence (OR = 0.83, 95% CI 0.28-2.47) for donors. For recipients, robotic surgery significantly reduced both grades 1-2 (OR = 0.70, 95% CI 0.53-0.94) and grades 3-4 complications (OR = 0.65, 95% CI 0.50-0.84), while showing comparable perioperative mortality (OR = 1.36, 95% CI 0.84-2.19), hepatic artery thrombosis (OR = 1.19, 95% CI 0.64-2.21), and biliary complications (OR = 1.01, 95% CI 0.52-1.97).
Conclusion
Robotic living donor right hepatectomy demonstrates comparable donor safety and superior effectiveness in reducing recipient complications.
Get full access to this article
View all access options for this article.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
