The Robotic Interval Surgery, A Game-Changer in Optimal Debulking for Ovarian Cancer: A Systematic Review and Meta-Analysis

机器人辅助间期手术:卵巢癌最佳减瘤术的变革性突破:系统评价和荟萃分析

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Abstract

PURPOSE: This study evaluates the role of robotic-interval debulking surgery (robotic IDS) compared to traditional laparotomy as the game-changer in surgical outcome and complications for ovarian cancer patients. PATIENTS AND METHODS: Following PRISMA guidelines, relevant literature published between 2014 and 2024 was retrieved from PubMed, Scopus, Google Scholar, EBSCOHost, and SAGE Journals. Out of 816 studies, four were included, assessed for bias using ROBINS-I and analyzed with random-effects meta-analysis with RevMan 5.4. RESULTS: A total of four studies involving 166 patients were analyzed. The findings indicate that robotic IDS has a significant result on achieving complete cytoreduction (OR of 6.67 [p = 0.0003]), reducing estimated blood loss (SMD of -0.71 [p = 0.02]), and shorter hospital stay (SMD of -1.58 [p<0.00001]). The result also shows promising effects on intraoperative complications with an OR of 0.82 [p=0.86] and postoperative complications with an OR of 0.40 [p=0.11]. Conversely, there is a longer operative time in robotic IDS compared to laparotomy with a SMD of 0.40 [p = 0.26]. CONCLUSION: Robotic IDS advances surgical management of advanced-stage (stage III-IV) and recurrent ovarian cancer, offering improved cytoreduction rates, reduced blood loss, and shorter hospital stays. A promising effect was also observed on intraoperative and postoperative complications, although operative time was longer. Further research is needed to demonstrate clearer clinical advantages.

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