Evidence map›Paper›PMID 42864674›Full record

SynthesisJournal of cardiothoracic surgery2026

Robotic-assisted versus conventional coronary artery bypass grafting: a systematic review, meta-analysis, and trial sequential analysis of 39,918 patients.

Ahmed Abdelsamad, Ibrahim Khalil, Mohammed Hrebat, Taher Abuawwad, Momen Zetawi, Basem Mohamed Yassin, Samer Imad Amayre, Mahmoud Ali Khazbak, Nadjet Laouadi, Shaimaa Khatib and 6 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Ahmed AbdelsamadDepartment of Surgery II, University of Witten/Herdecke, Witten, Germany. ahmed6361410@gmail.com.ORCID https://orcid.org/0000-0002-5451-4504
Ibrahim KhalilFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Mohammed HrebatFaculty of Medicine, Tanta University, Tanta, Egypt.
Taher AbuawwadFujian Medical University, Fujian, China.
Momen ZetawiFaculty of Medicine, An-Najah National University, Nablus, Palestine.
Basem Mohamed YassinFaculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Samer Imad AmayreFaculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Mahmoud Ali KhazbakMinistry of Health, Muscat, Oman.
Nadjet LaouadiHeart Center, King Abdulaziz Specialized Hospital, Al Jouf, Saudi Arabia.
Shaimaa KhatibFaculty of Medicine, An-Najah National University, Nablus, Palestine.
Hamza Motaz AtallaFaculty of Medicine, An-Najah National University, Nablus, Palestine.
Layth Adnan ManasraFaculty of Medicine, Cairo University, Cairo, Egypt.
Abdellatif QaraqeFaculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Baraa MansourFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Tarig Mohamed Abdelatief AbdeldaimOmdurman Islamic University, Omdurman, Sudan.
Tamer GhazyDepartment of Cardiac Surgery, Philipps University of Marburg, Marburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobotic-assisted coronary artery bypass grafting (RA-CABG) is an evolving minimally invasive alternative to conventional CABG (C-CABG), but comparative evidence remains fragmented. We conducted a comprehensive systematic review, meta-analysis, and trial sequential analysis to compare outcomes between RA-CABG and C-CABG.

methodsFollowing PRISMA 2020 guidelines, we searched PubMed, Embase, Cochrane CENTRAL, and Web of Science through January 2026. Studies comparing RA-CABG to C-CABG reporting at least one outcome of interest were eligible. Random-effects meta-analyses using DerSimonian-Laird estimators were performed. Risk of bias was assessed using ROBINS-I. Trial sequential analysis evaluated the conclusiveness of cumulative evidence.

resultsNine studies comprising 39,918 patients (13,638 RA-CABG; 26,280 C-CABG) were included. All included studies were observational in design, and long-term outcome data were sparse. RA-CABG was associated with significantly lower mortality (OR 0.55, 95% CI 0.43-0.69; P < 0.001; I²=0%), atrial fibrillation (OR 0.53; P < 0.001), respiratory failure (OR 0.31; P < 0.001), blood transfusion (OR 0.28; P < 0.001), hospital length of stay (MD - 1.95 days; P < 0.001), and ICU stay (MD - 22.7 h; P < 0.001). Stroke showed a non-significant trend favoring RA-CABG (OR 0.76; P = 0.071). Trial sequential analysis confirmed conclusive evidence for mortality, atrial fibrillation, respiratory failure, and blood transfusion. Results were robust across sensitivity analyses.

conclusionsIn this meta-analysis of observational studies, RA-CABG was associated with significantly improved short-term outcomes compared to C-CABG across multiple endpoints, with conclusive statistical evidence for four of seven binary outcomes. However, all included studies were observational, and these associations should be interpreted with caution given potential residual confounding and case-selection bias. Multicenter randomized trials with long-term follow-up are needed to confirm these findings.

Indexed as

Coronary Artery BypassCoronary Artery DiseaseRobotic Surgical ProceduresHumansPostoperative ComplicationsCABGCoronary artery bypass graftingMeta-analysisMinimally invasive cardiac surgeryRobotic surgeryTECABTrial sequential analysis

Identifiers

PMID42864674
PMCPMC13660123

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.