TY - JOUR
T1 - Comparison of perioperative outcomes between robotic and laparoscopic partial nephrectomy
T2 - A systematic review and meta-analysis
AU - Choi, Ji Eun
AU - You, Ji Hye
AU - Kim, Dae Keun
AU - Rha, Koon Ho
AU - Lee, Seon Heui
N1 - Publisher Copyright:
© 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Context Robotic partial nephrectomy (RPN) is rapidly increasing; however, the benefit of RPN over laparoscopic partial nephrectomy (LPN) is controversial. Objective To compare perioperative outcomes of RPN and LPN. Evidence acquisition We searched Ovid-Medline, Ovid-Embase, the Cochrane Library, KoreaMed, KMbase, KISS, RISS, and KisTi from their inception through August 2013. Two independent reviewers extracted data using a standardized form. Quality of the selected studies was assessed using the methodological index for nonrandomized studies. Evidence synthesis A total of 23 studies and 2240 patients were included. All studies were cohort studies with no randomization, and the methodological quality varied. There was no significant difference between the two groups regarding complications of Clavien-Dindo classification grades 1-2 (p = 0.62), Clavien-Dindo classification grades 3-5 (p = 0.78), change of serum creatinine (p = 0.65), operative time (p = 0.35), estimated blood loss (p = 0.76), and positive margins (p = 0.75). The RPN group had a significantly lower rate of conversion to open surgery (p = 0.02) and conversion to radical surgery (p = 0.0006), shorter warm ischemia time (WIT; p = 0.005), smaller change of estimated glomerular filtration rate (eGFR; p = 0.03), and shorter length of stay (LOS; p = 0.004). Conclusions This meta-analysis shows that RPN is associated with more favorable results than LPN in conversion rate to open or radical surgery, WIT, change of eGFR, and shorter LOS. To establish the safety and effectiveness outcomes of robotic surgery, well-designed randomized clinical studies with long-term follow-up are needed. Patient summary Robotic partial nephrectomy (PN) is more favorable than laparoscopic PN in terms of lower conversion rate to radical nephrectomy, a favorable renal function indexed estimated glomerular filtration rate, shorter length of hospital stay, and shorter warm ischemia time.
AB - Context Robotic partial nephrectomy (RPN) is rapidly increasing; however, the benefit of RPN over laparoscopic partial nephrectomy (LPN) is controversial. Objective To compare perioperative outcomes of RPN and LPN. Evidence acquisition We searched Ovid-Medline, Ovid-Embase, the Cochrane Library, KoreaMed, KMbase, KISS, RISS, and KisTi from their inception through August 2013. Two independent reviewers extracted data using a standardized form. Quality of the selected studies was assessed using the methodological index for nonrandomized studies. Evidence synthesis A total of 23 studies and 2240 patients were included. All studies were cohort studies with no randomization, and the methodological quality varied. There was no significant difference between the two groups regarding complications of Clavien-Dindo classification grades 1-2 (p = 0.62), Clavien-Dindo classification grades 3-5 (p = 0.78), change of serum creatinine (p = 0.65), operative time (p = 0.35), estimated blood loss (p = 0.76), and positive margins (p = 0.75). The RPN group had a significantly lower rate of conversion to open surgery (p = 0.02) and conversion to radical surgery (p = 0.0006), shorter warm ischemia time (WIT; p = 0.005), smaller change of estimated glomerular filtration rate (eGFR; p = 0.03), and shorter length of stay (LOS; p = 0.004). Conclusions This meta-analysis shows that RPN is associated with more favorable results than LPN in conversion rate to open or radical surgery, WIT, change of eGFR, and shorter LOS. To establish the safety and effectiveness outcomes of robotic surgery, well-designed randomized clinical studies with long-term follow-up are needed. Patient summary Robotic partial nephrectomy (PN) is more favorable than laparoscopic PN in terms of lower conversion rate to radical nephrectomy, a favorable renal function indexed estimated glomerular filtration rate, shorter length of hospital stay, and shorter warm ischemia time.
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U2 - 10.1016/j.eururo.2014.12.028
DO - 10.1016/j.eururo.2014.12.028
M3 - Review article
C2 - 25572825
AN - SCOPUS:84926205878
SN - 0302-2838
VL - 67
SP - 891
EP - 901
JO - European Urology
JF - European Urology
IS - 5
ER -