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Perioperative outcomes of robotic-assisted versus traditional surgery for DIEP flap breast reconstruction: a systematic review and meta-analysis.

Journal of robotic surgery 2026 Vol.20(1) p. 156

Xu X, Hou J, Lv Z, Zeng X, Hu Y, Wang Y, Lan P, Qin P

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유방 Breast 피판재건술 Flap Reconstruction 혈종 Hematoma 장액종 Seroma 감염 Infection

Abstract

[BACKGROUND] Breast cancer has the highest incidence among female malignancies, and surgical intervention remains a cornerstone of its management. However, destructive procedures such as traditional mastectomy or breast-conserving surgery can significantly alter patients' physical appearance and self-perception, thereby compromising their quality of life. Robotic technology has enabled new directions for minimal invasive breast surgery. The purpose of this analysis is to investigate differences in complication rates between robotic assisted DIEP flap breast reconstruction and conventional DIEP flap breast reconstruction.

[METHODS] A comprehensive literature scan on PubMed, Web of Science, Embase, and The Cochrane Library was performed for clinical studies, specifically for comparative clinical studies (including RCTs if available), on robotic assisted DIEP flap breast reconstruction, compared with conventional DIEP flap breast reconstruction. Primary outcome measures included complete flap loss, delayed wound healing, donor-site seroma, hematoma, and infection. Secondary outcomes encompassed operative duration, postoperative hospital stay, and patient-reported aesthetic scores. For categorical variables, odds ratios (OR) were used, while for continuous variables, mean differences (MD), were employed, with 95% confidence intervals (CI) for both.

[RESULTS] A total of five studies with 691 participants were employed. No significant differences were found in major complication rates, such as complete flap loss, healing delay, seroma, hematoma, or infection, between groups. Compared with the conventional group, there were significantly longer operative times in the robotic group (MD = 62.82, 95% CI [37.75, 87.90], P < 0.001) while hospital stays were significantly shorter in the robotic group (MD = -0.61, 95% CI [-1.03, -0.20], P = 0.003).

[CONCLUSIONS] Harvesting DIEP flaps with robotic assistance is safe and feasible. Its clinical application is associated with reduced hospitalization duration and increased operative time. This approach demonstrates potential for improving aesthetic outcomes and patient satisfaction, positioning it as a promising surgical option in clinical practice. Nevertheless, long-term follow-ups are needed to reaffirm its safety and efficacy in oncological practice.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
해부 breast 유방 dict 8
시술 diep flap 피판재건술 dict 5
시술 flap 피판재건술 dict 2
합병증 hematoma 혈종 dict 2
합병증 seroma 장액종 dict 2
합병증 infection 감염 dict 2

MeSH Terms

Humans; Robotic Surgical Procedures; Mammaplasty; Female; Postoperative Complications; Breast Neoplasms; Treatment Outcome; Operative Time; Length of Stay; Perforator Flap; Mastectomy

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외부 PMID 30건 (DB 미수집)

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