Comparison of Robot-Assisted Versus Open Partial Nephrectomy for Treating Renal Malignancies With An Emphasis on...

Robotic assisted partial nephrectomy (RaPN) is the treatment of choice for small and resectable renal tumors offering better results in terms of blood loss, postoperative complications and length of hospital stay compared with the open partial nephrectomy (OPN), while for both techniques the risk of postoperative renal dysfunction is limited. However, the oncologic outcomes of the robotic procedure are yet to be determined. Therefore, a comprehensive research of PubMed/Medline, Embase and Scopus databases from the year 2000 till June 2024 was performed to elucidate the results related to oncologic outcomes. The ROBINS-I tool for non-randomized cohort studies was applied for the assessment of the quality of the included studies. All statistical analyses were performed with the use of STATA software version 15.0.

The study was registered in International Platform of Registered Systematic Review and Metaanalysis Protocols database with the registration number INPLASY202450054. Overall 11 studies with 4758 patients were included in the present systematic review and meta-analysis. No statistically significant difference between the two treatment methods was reconded for the outcomes of overall survival [HR: 1.23 (95% CI: 0.68, 2.20)- p = 0.488], disease-specific survival [OR: 2.53 (95% CI: 0.65, 9.78)- p = 0.179], progression-free survival [HR: 1.04 (95% CI: 0.60, 1.79)- p = 0.901], recurrence-free survival [HR: 0.83 (95% CI = 0.54, 1.27)-p = 0.394] and disease-free survival [OR: 1.01 (95% CI = 0.98, 1.03)-p = 0.582]. The quality of most of the included studies was deemed moderate. Despite the need for more high quality comparative studies it is assumed that these results could be helpful in decision making and in counselling patients with resectable renal tumors to whom a nephron sparing surgery may be considered.