title: Systematic review and meta-analysis of comparative studies reporting early outcomes after robot-assisted radical cystectomy versus open radical cystectomy.
abstract: BACKGROUND
  Robot-assisted radical cystectomy (RARC) is increasingly being used in the management of bladder cancer. Studies comparing RARC and open radical cystectomy (ORC) have reported conflicting results. We conducted a systematic review and meta-analysis of the literature on the efficacy and advantages of RARC compared with ORC.
  
  
  METHODS
  An electronic database search of PubMed, Scopus, and the Cochrane Library was performed up to July 8, 2012. This systematic review and meta-analysis was performed based on all randomized controlled trials (RCTs) and observational comparative studies assessing the two techniques.
  
  
  RESULTS
  One RCT, eight studies with prospectively collected data, and four retrospective studies were identified, including 962 cases. Although RARC was associated with longer operative time (p<0.001), patients in this group might benefit from less overall perioperative complications (p=0.04), more lymph node yield (p=0.009), less estimated blood loss (p<0.001), a lower need for perioperative transfusion (p<0.001), and shorter length of hospital stay (p<0.001). Positive surgical margins did not differ significantly between techniques. Sensitivity analysis with prospective studies showed similar results to the original analysis, but no significant difference of lymph node yield and length of stay between two techniques.
  
  
  CONCLUSIONS
  RARC is a mini-invasive alternative to ORC with less overall perioperative complications, more lymph node yields, less estimated blood loss, less need for a perioperative transfusion, and shorter length of stay.
authors.affiliation: Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 W Yanjiang Road, Guangzhou 510020, China.
authors.forename: Kaiwen
authors.initials: K
authors.lastname: Li
authors.forename: Tianxin
authors.initials: T
authors.lastname: Lin
authors.forename: Xinxiang
authors.initials: X
authors.lastname: Fan
authors.forename: Kewei
authors.initials: K
authors.lastname: Xu
authors.forename: Liangkuan
authors.initials: L
authors.lastname: Bi
authors.forename: Yu
authors.initials: Y
authors.lastname: Duan
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhou
authors.forename: Min
authors.initials: M
authors.lastname: Yu
authors.forename: Jielin
authors.initials: J
authors.lastname: Li
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
mesh_terms: D015653:Cystectomy / Q000379:methods*; D006801:Humans; D011446:Prospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*