Sheng-Han Tsai1,2, Ping-Tao Tseng3,4, Benjamin A Sherer5, Yi-Chen Lai2,6, Pao-Yen Lin7,8, Ching-Kuan Wu3, Marshall L Stoller5. 1. Department of Urology, Cheng Hsin General Hospital, Taipei City, Taiwan. 2. School of Medicine, National Yang-Ming University, Taipei, Taiwan. 3. Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung, Taiwan. 4. WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan. 5. Department of Urology, University of California, San Francisco, San Francisco, California. 6. Department of Radiology, Veteran General Hospital, Taipei, Taiwan. 7. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. 8. Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Abstract
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.
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.
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