Robot-assisted Radical Nephrectomy: A Systematic Review and Meta-analysis of Comparative Studies

Radical nephrectomy (RN) is the gold standard treatment for large and locally advanced renal tumors. Although robot-assisted radical nephrectomy (RRN) is being increasingly adopted, it remains unclear whether it offers benefits over standard laparoscopic radical nephrectomy (LRN) or open radical nep...

Full description

Saved in:
Bibliographic Details
Published in:European urology 2021-10, Vol.80 (4), p.428-439
Main Authors: Crocerossa, Fabio, Carbonara, Umberto, Cantiello, Francesco, Marchioni, Michele, Ditonno, Pasquale, Mir, Maria C., Porpiglia, Francesco, Derweesh, Ithaar, Hampton, Lance J., Damiano, Rocco, Autorino, Riccardo
Format: Article
Language:English
Subjects:
Carcinoma, Renal Cell - surgery
Humans
Kidney neoplasms
Kidney Neoplasms - surgery
Laparoscopy
Laparoscopy - adverse effects
Length of Stay
Nephrectomy - adverse effects
Postoperative Complications - etiology
Prospective Studies
Radical nephrectomy
Retrospective Studies
Robotics
Treatment Outcome
Treatment outcomes
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Radical nephrectomy (RN) is the gold standard treatment for large and locally advanced renal tumors. Although robot-assisted radical nephrectomy (RRN) is being increasingly adopted, it remains unclear whether it offers benefits over standard laparoscopic radical nephrectomy (LRN) or open radical nephrectomy (ORN). To compare the outcomes of robotic surgery to those of laparoscopic and open surgery in patients undergoing RN for renal cell carcinoma (RCC). A systematic search was performed across MEDLINE, EMBASE, and Web of Science for retrospective and prospective studies comparing RRN to LRN or ORN. A meta-analysis evaluated perioperative safety, effectiveness, survival, and cost-effectiveness outcomes. The weighted mean difference (WMD) and odds ratio (OR) were used to compare continuous and dichotomous variables, respectively. Quality was assessed using the Newcastle-Ottawa scale. Sensitivity analyses were performed to assess the robustness of the estimates. Twelve studies involving 64 221 patients were identified and included in the analysis. Compared to LRN, RRN was associated with statistically significant longer operative time (WMD 37.44 min; p =  0.03), shorter length of stay (WMD –0.84 days; p =  0.02) and higher total costs (WMD US$4700; p < 0.001). Compared to ORN, RRN was associated with shorter length of stay (WMD –3.06 days; p =  0.002), fewer overall complications (OR 0.56; p 
ISSN:0302-2838
1873-7560
DOI:10.1016/j.eururo.2020.10.034