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Open versus robotic partial nephrectomy: Systematic review and meta‐analysis of contemporary studies
Author(s) -
Tsai ShengHan,
Tseng PingTao,
Sherer Benjamin A.,
Lai YiChen,
Lin PaoYen,
Wu ChingKuan,
Stoller Marshall L.
Publication year - 2019
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.1963
Subject(s) - medicine , nephrectomy , renal function , meta analysis , blood loss , subgroup analysis , perioperative , cochrane library , surgery , confounding , body mass index , urology , kidney
Objectives To compare perioperative outcomes of robotic‐assisted partial nephrectomy (RaPN) with open partial nephrectomy (OPN). Methods Systematically search through PubMed, Embase, ClinicalKey, Cochrane Library, ProQuest, ScienceDirect, Web of Science, and ClinicalTrials.gov for eligible studies was performed to April 11, 2018. A meta‐analysis was conducted for studies comparing RaPN and OPN. Confounding variables were assessed by meta‐regression or subgroup analysis. Results This study included 34 studies with 60 808 patients. Meta‐analysis revealed less blood loss, less transfusion, longer operative time, less postoperative complications, lower readmission rate, shorter length of stay, and less estimated glomerular filtration rate (eGFR) decline in RaPN groups. The superiority of RaPN in blood loss was attenuated with highly complex renal masses. The superiority of RaPN in intraoperative complications was strengthened with renal hilar control. The advantage of RaPN in surgical margin was increased in patient with body mass index (BMI) < 28. Conclusions Compared with OPN, RaPN provided lower morbidities and better renal function preservation.