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Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis.
Bracale, U; Corcione, F; Neola, D; Castiglioni, S; Cavallaro, G; Stabilini, C; Botteri, E; Sodo, M; Imperatore, N; Peltrini, R.
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  • Bracale U; Department of General and Specialistic Surgeries, Federico II University Hospital, Naples, Italy.
  • Corcione F; Department of General and Specialistic Surgeries, Federico II University Hospital, Naples, Italy.
  • Neola D; Department of Public Health, University of Naples Federico II, Naples, Italy.
  • Castiglioni S; Department of General and Specialistic Surgeries, Federico II University Hospital, Naples, Italy.
  • Cavallaro G; Department of General and Specialistic Surgeries, Federico II University Hospital, Naples, Italy.
  • Stabilini C; Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio Chieti-Pescara, Pescara, Italy.
  • Botteri E; Department of Surgery "P. Valdoni", University of Rome "La Sapienza", Rome, Italy.
  • Sodo M; Department of Surgical Sciences, University of Genoa, Policlinico San Martino IRCCS, Genoa, Italy.
  • Imperatore N; General Surgery, ASST Spedali Civili Di Brescia, Brescia, Italy.
  • Peltrini R; Department of Public Health, University of Naples Federico II, Naples, Italy.
Hernia ; 25(6): 1471-1480, 2021 12.
Article en En | MEDLINE | ID: mdl-34491460
PURPOSE: To compare early postoperative outcomes after transversus abdominis release (TAR) for ventral hernia repair with open (oTAR) and robotic (rTAR) approach. METHODS: A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Web of Science databases was conducted to identify comparative studies until October 2020. A meta-analysis of postoperative short-term outcomes was performed including complications rate, operative time, length of stay, surgical site infection (SSI), surgical site occurrence (SSO), SSO requiring intervention (SSOPI), systemic complications, readmission, and reoperation rates as measure outcomes. RESULTS: Six retrospective studies were included in the analysis with a total of 831 patients who underwent rTAR (n = 237) and oTAR (n = 594). Robotic TAR was associated with lower risk of complications rate (9.3 vs 20.7%, OR 0.358, 95% CI 0.218-0.589, p < 0.001), lower risk of developing SSO (5.3 vs 11.5%, OR 0.669, 95% CI 0.307-1.458, p = 0.02), lower risk of developing systemic complications (6.3 vs 26.5%, OR 0.208, 95% CI 0.100-0.433, p < 0.001), shorter hospital stay (SMD - 4.409, 95% CI - 6.000 to - 2.818, p < 0.001) but longer operative time (SMD 53.115, 95% CI 30.236-75.993, p < 0.01) compared with oTAR. There was no statistically significant difference in terms of SSI, SSOPI, readmission, and reoperation rates. CONCLUSION: Robotic TAR improves recovery by adding the benefits of minimally invasive procedures when compared to open surgery. Although postoperative complications appear to decrease with a robotic approach, further studies are needed to support the real long-term and cost-effective advantages.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Robotizados / Hernia Ventral Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Francia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Robotizados / Hernia Ventral Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Francia