Comparison of peri-operative outcomes of robot-assisted vs laparoscopic partial nephrectomy: a meta-analysis.
OBJECTIVE
To conduct a meta-analysis of the literature on the peri-operative outcomes of both robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN).


METHODS
An electronic database search of MEDLINE, EMBASE, Google Scholar and the Cochrane Library was performed for publications up to 8 January 2013. All studies comparing RAPN with LPN were included. The outcome measures were demographic and peri-operative results, including operating time, warm ischaemia time, blood loss, length of hospital stay, conversion rates, positive surgical margins and complications. A meta-analysis of the results was conducted.


RESULTS
A total of 766 patients were included, 425 patients in the RAPN group and 341 patients in the LPN group. There was no significant difference between the two groups in any of the demographic variables (age: P = 0.89; sex: P = 0.31; malignant pathology: P = 0.54; tumour size: P = 0.99; tumour laterality: P = 0.06). There was no difference between the two groups regarding operating times (P = 0.75), estimated blood loss (P = 0.75), conversion rates (P = 0.52), positive surgical margins (P = 0.61), complications (P = 0.27) or length of hospital stay (P = 0.27), but the RAPN group had significantly shorter warm ischaemia times than the LPN group (P = 0.01; weighted mean difference: -3.65; 95% confidence interval, -6.46 to -0.83).


CONCLUSIONS
This meta-analysis shows that RAPN provides equivalent peri-operative outcomes to those of LPN, with the added advantage of a significantly shorter warm ischaemia time.
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Xiaohua
X
Zhang
Zhoujun
Z
Shen
Shan
S
Zhong
Zhaowei
Z
Zhu
Xianjin
X
Wang
Tianyuan
T
Xu
D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D059035:Perioperative Period; D011183:Postoperative Complications / Q000209:etiology*; D012371:Robotics; D016019:Survival Analysis; D016896:Treatment Outcome; D052096:Warm Ischemia / Q000009:adverse effects / Q000706:statistics & numerical data*
laparoscopic; meta-analysis; nephron-sparing; partial nephrectomy; renal tumour; robot