SynthesisJournal of robotic surgery2025
Evaluating robotic vs. laparoscopic liver resection for BCLC stage 0-I hepatocellular carcinoma: a meta-analysis of propensity score-matched studies on perioperative outcomes.
Synthesis in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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17 authors.
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Abstract
Hepatocellular carcinoma (HCC) is still a leading indication of Surgical resection of a portion of the liver. Laparoscopic and robotic liver resections are some of the techniques that are becoming increasingly common. Although RLR is more dextrous and precise, its benefits over LLR remain controversial because of the variation in the methodology of studies and patient selection. This meta-analysis compared perioperative outcomes between robotic and laparoscopic liver resection in HCC, focusing on operative time, hospital stay, morbidity, mortality, transfusion needs, and bile leak rates. The quality of evidence was assessed using the GRADE approach. A systematic search of PubMed, Scopus, and Cochrane identified 520 records. Five multicenter propensity score-matched cohort studies involving 3,616 patients (Robotic: 3,283; Laparoscopic: 333) met the inclusion criteria. Data on perioperative outcomes were pooled, and the Newcastle-Ottawa Scale (NOS) was used to evaluate the methodological quality of the studies. Compared with laparoscopic resection, robotic liver resection had a longer operative time (MD: -35.15 min, 95% CI: -64.90 to - 5.39; p = 0.02; I² = 38%). However, there were no significant differences in blood transfusion rates (RR: 1.50, 95% CI: 0.41-5.47; p = 0.54), bile leaks (RR: 2.11, 95% CI: 0.59-7.52; p = 0.25), hospital stays (MD: -0.19 days, 95% CI: -2.42 to 2.05; p = 0.87; I² = 95%), or conversion to open surgery (RR: 1.22, 95% CI: 0.42-3.59; p = 0.71). RLR showed higher 30-day morbidity (RR: 1.59, 95% CI: 1.04-2.42; p = 0.03), while 90-day mortality did not differ significantly between the two approaches (RR: 4.33, 95% CI: 0.84-22.41; p = 0.08). RLR yields comparable results to LLR in HCC, with no differences in mortality or conversion rates but longer operative times and slightly higher short-term morbidity. Evidence quality was low to very low, emphasizing the need for well-designed randomized trials to inform surgical choices.
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