Robot-assisted versus laparoscopic partial nephrectomy for localized renal tumors: a meta-analysis

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Robot-assisted partial nephrectomy (RAPN) is increasingly used for localized renal tumors.
• Efficacy of RAPN compared to standard laparoscopic partial nephrectomy (LPN) remains unclear.
• This meta-analysis compares perioperative and oncologic outcomes of RAPN versus LPN.

Purpose of the Study:

• To compare Robot-assisted partial nephrectomy (RAPN) and Laparoscopic partial nephrectomy (LPN).
• To evaluate perioperative and oncologic outcomes for localized renal tumors.
• To synthesize evidence from comparative studies.

Main Methods:

• Systematic literature search of MEDLINE, EMBASE, and OVID databases.
• Inclusion of 14 comparative studies with 1539 participants.
• Statistical analysis using mean difference (MD) and odds ratio (OR) with 95% confidence intervals (CI); quality assessed by Newcastle-Ottawa scale.

Main Results:

• Similar operative time, estimated blood loss (EBL), and length of stay (LOS) between RAPN and LPN.
• RAPN demonstrated a significantly decreased warm ischemia time (WIT) compared to LPN.
• No significant differences in intraoperative, minor, or major postoperative complications, or positive surgical margin rates.

Conclusions:

• RAPN shows comparable operative time, EBL, LOS, perioperative complications, and positive margin rates to LPN.
• RAPN offers a significant advantage in reducing warm ischemia time.
• Long-term follow-up studies are necessary to compare long-term complications and oncologic outcomes.