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Perbandingan efikasi dan keamanan kolesistektomi robotik dengan laparoskopik konvensional: sebuah systematic review

Abstract

Background: Laparoscopic cholecystectomy is currently the gold standard for treating gallbladder disorders, replacing open cholecystectomy. With the development of medical technology, robotic cholecystectomy techniques are being developed as an alternative to laparoscopic cholecystectomy. This systematic review compares the efficacy and safety of conventional laparoscopic and robotic cholecystectomy.

Methods: Study searches were carried out on four electronic scientific journal publication databases: PubMed, Wiley Online Library, JAMA Network, and Google Scholar. The study selection method used the PRISMA diagram with inclusion criteria in studies comparing robotic and laparoscopic cholecystectomy and samples of adult patients aged ≥18 years. Meanwhile, study exclusion criteria are studies not available in full (full-text)) not available in Indonesian or English, and studies in the form of meta-analyses, reviews, systematic reviews, case reports, or commentaries.

Results: The thirteen studies in this systematic review consisted of 11 retrospective cohort studies and two randomized clinical trials involving 69,973 (1.62%) undergoing robotic cholecystectomy and 4,244,444 (98.38%) patients undergoing laparoscopic cholecystectomy. From the results of the synthesis analysis, it was found that most studies found that the duration of operation was significantly longer in robotic cholecystectomy. Length of hospital stay, pain scale, and complication rates were lower in robotic cholecystectomy. In terms of cost, robotic cholecystectomy costs significantly more than laparoscopic cholecystectomy.

Conclusion: Compared with laparoscopic cholecystectomy, robotic cholecystectomy requires higher operating time and costs but with a lower length of stay, pain scale, and complication rate.

 

Latar Belakang: Kolesistektomi laparoskopik merupakan standar baku emas untuk tindakan pembedahan kelainan kandung empedu saat ini, menggantikan kolesistektomi terbuka. Dengan perkembangan teknologi kedokteran, teknik kolesistektomi robotik tengah dikembangkan sebagai alternatif kolesistektomi laparoskopik. Systematic review ini bertujuan untuk membandingkan efikasi dan keamanan kolesistektomi robotik dan laparoskopik kovensional.

Metode: Pencarian studi dilakukan pada empat basis data publikasi jurnal ilmiah elektronik yakni PubMed, Wiley Online Library, JAMA Network, dan Google Scholar. Metode pemilihan studi menggunakan diagram PRISMA dengan kriteria inklusi berupa studi yang membandingkan antara kolesistektomi robotic dan laparoskopik dan sampel berupa pasien dewasa berusia ≥18 tahun. Sedangkan kriteria eksklusi studi adalah: studi tidak tersedia secara lengkap (full-text),) tidak tersedia dalam Bahasa Indonesia atau Inggris, serta studi berupa meta-analisis, review, systematic review, laporan kasus, atau commentary.

Hasil: Tiga belas studi yang diikutsertakan dalam systematic review ini terdiri dari 11 studi kohort retrospektif dan dua uji klinis acak dengan melibatkan sebanyak sebanyak 69.973 (1,62%) menjalani kolesistektomi robotik dan sebanyak 4.244.444 (98,38%) pasien menjalani kolesistektomi laparoskopik. Dari hasil analisis sintesis didapatkan mayoritas studi menemukan durasi waktu operasi yang signifikan lebih panjang pada kolesistektomi robotik. Durasi waktu rawat inap, skala nyeri, dan tingkat komplikasi yang lebih rendah pada kolesistektomi robotik. Dari segi biaya, kolesistektomi robotik menghabiskan biaya yang signifikan lebih besar dibandingkan kolesistektomi laparoskopik.

Kesimpulan: Dibandingkan kolesistektomi laparoskopik, kolesistektomi robotik menghabiskan waktu operasi dan biaya yang lebih tinggi, namun dengan durasi rawat inap, skala nyeri, dan tingkat komplikasi yang lebih rendah.

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How to Cite

Mahartama, I. K. A., & Partama, I. P. G. (2023). Perbandingan efikasi dan keamanan kolesistektomi robotik dengan laparoskopik konvensional: sebuah systematic review. Intisari Sains Medis, 14(3), 1313–1321. https://doi.org/10.15562/ism.v14i3.1905

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