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Robotic versus open partial nephrectomy: a systematic review and meta-analysis.

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  • 1Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, P. R. China.

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Robotic partial nephrectomy (RPN) offers lower complication rates, shorter hospital stays, and less blood loss compared to open partial nephrectomy (OPN). Further high-quality studies are needed to confirm these benefits for kidney cancer treatment.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Partial nephrectomy is the gold standard for small renal masses.
  • Robotic partial nephrectomy (RPN) and open partial nephrectomy (OPN) are surgical options.
  • Comparative evidence on the outcomes of RPN versus OPN is evolving.

Purpose of the Study:

  • To critically review and synthesize existing evidence comparing RPN and OPN.
  • To evaluate perioperative outcomes, complications, and functional results.

Main Methods:

  • Comprehensive literature search of PubMed, Web of Science, and Scopus.
  • Inclusion of all comparative studies of RPN versus OPN.
  • Cumulative meta-analysis of extracted data and assessment of publication bias.

Main Results:

  • Eight studies with 3418 patients (757 RPN, 2661 OPN) were analyzed.
  • RPN demonstrated significantly lower perioperative complication rates (19.3% vs 29.5%), shorter hospital stays (p<0.00001), and less blood loss (p=0.003).
  • Operative time was longer for RPN (p=0.002), while transfusions, conversion rates, ischemia time, GFR change, margin status, and cost were comparable.

Conclusions:

  • RPN is an efficient alternative to OPN, offering reduced perioperative complications, shorter hospital stays, and less blood loss.
  • The findings suggest RPN provides comparable oncological and functional outcomes.
  • High-quality prospective randomized trials with longer follow-up are warranted to solidify these conclusions.