A systematic review and meta-analysis of conventional laparoscopic sacrocolpopexy versus robot-assisted laparoscopic sacrocolpopexy

摘要

BACKGROUND: Robot-assisted laparoscopic sacrocolpopexy (RALSC) has spread rapidly without the availability of comprehensive and systematically recorded outcome data. OBJECTIVE: To systematically review and compare the outcomes of laparoscopic sacrocolpopexy (LSC) and RALSC. SEARCH STRATEGY: PubMed and Scopus were searched for reports published from 2000 to 2014, using the search terms "robotic sacrocolpopexy," "laparoscopic sacrocolpopexy," and "sacral colpopexy." SELECTION CRITERIA: Studies were included if they directly compared the outcomes of RALSC and LSC, the sample size in each group was more than 15, the follow-up duration was longer than 3 months, and the report was in English. DATA COLLECTION AND ANALYSIS: The studies' characteristics, quality, and outcomes were recorded. Random-/fixed-effects models were used to combine data. MAIN RESULTS: Data on 264 RALSC and 267 LSC procedures were collected from seven studies. The mean operative time was longer in the RALSC group (245.9 minutes vs 205.9 minutes; P<0.001). The estimated blood loss in the two groups was similar (114.4 mL vs 160.1 mL; P=0.36). The differences in incidence of intraoperative/postoperative complications were also similar (P=0.85 vs P=0.92). The costs of RALSC were significantly higher than were those of LSC series in each of three studies (P<0.01 for all). CONCLUSIONS: The clinical outcomes of prolapse surgery are similar with RALSC and LSC, but RALSC is less efficient in terms of cost and time.