Abstract：
Current meta-analysis was performed to compare robotic hepatectomy (RH) with conventional open hepatectomy (OH) in terms of peri-operative and postoperative outcomes. PubMed, EMBASE, and the Cochrane Library were all searched up for comparative studies between RH and OH. RevMan5.3 software and Stata 13.0 software were used for statistical analysis. Nineteen studies with 1747 patients who received RH and 23,633 patients who received OH were included. Pooled results indicated that patients who received RH were generally younger than those received OH (P < 0.00001). Moreover, RH was associated with longer operative time (P = 0.0002), less intraoperative hemorrhage (P < 0.0001), lower incidence of intraoperative transfusion (P = 0.003), lower incidence of postoperative any morbidity (P < 0.00001), postoperative major morbidity (P = 0.0001), mortalities with 90 days after surgery (P < 0.0001), and shorter length of postoperative hospital stay (P < 0.00001). Comparable total hospital costs were acquired between RH and OH groups (P = 0.46). However, even at the premise of comparable R0 rate (P = 0.86), RH was associated with smaller resected tumor size (P < 0.00001). Major hepatectomy (P = 0.02) and right posterior hepatectomy (P = 0.0003) were less frequently performed in RH group. Finally, we concluded that RH was superior to OH in terms of peri-operative and postoperative outcomes. RH could lead to less intraoperative hemorrhage, less postoperative complications and an enhanced postoperative recovery. However, major hepatectomy and right posterior hepatectomy were still less frequently performed via robotic approach. Future more powerful well-designed studies are required for further exploration.
摘要：
进行当前的荟萃分析，以比较机器人肝切除术（RH）与传统开放式肝切除术（OH）的围手术期和术后结果。PubMed,EMBASE,和Cochrane图书馆都进行了RH和OH之间的比较研究。采用RevMan5.3软件和Stata13.0软件进行统计分析。纳入了19项研究，其中1747例接受RH的患者和23,633例接受OH的患者。汇总结果表明，接受RH的患者通常比接受OH的患者年轻（P<0.00001）。此外，RH与手术时间长相关(P=0.0002),术中出血少（P<0.0001），术中输血发生率较低（P=0.003），术后任何发病率的发生率较低（P<0.00001），术后主要发病率（P=0.0001），手术后90天的死亡率（P<0.0001），术后住院时间缩短(P<0.00001)。RH组和OH组之间的总住院费用相当（P=0.46）。然而,即使在R0率相当的前提下(P=0.86)，RH与较小的切除肿瘤大小相关(P<0.00001)。RH组肝切除术（P=0.02）和右后肝切除术（P=0.0003）的频率较低。最后,我们的结论是,就围手术期和术后结局而言,RH优于OH.RH可以减少术中出血，术后并发症少，术后恢复加快。然而,通过机器人入路进行大肝切除术和右后肝切除术的频率仍然较低。未来需要更强大的精心设计的研究来进一步探索。
