Systematic review and meta-analysis of randomised trials of perioperative outcomes comparing robot-assisted versus open radical cystectomy.
BACKGROUND
With the introduction of robotic surgery, whether the robot-assisted radical cystectomy (RARC) could reduce the perioperative morbidity compared with Open radical cystectomy (ORC) was unknown.


METHODS
Studies reported RARC were reviewed based on all randomized controlled trials (RCTs), which focused on the efficacy of RARC versus ORC.


RESULTS
Of the 201 studies from preliminary screening, four RCTs were included. By pooling these studies, there were significant differences in comparison of operative time (p = 0.007), estimated blood loss (EBL) (p < 0.001) and time to diet (p < 0.001) between the RARC group and ORC groups. There was no significant difference regarding perioperative complications (Clavien 2-5, Clavien 3-5), length of stay (LOS), positive surgical margins (PSM) and lymph node positive.


CONCLUSIONS
This meta-analysis presented evidence for a benefit of EBL, time to diet, similar perioperative complications and oncological outcomes, but a longer operative time in RARC. It is noted that RARC was considered as a comparable surgical procedure to ORC.
Department of Urology, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China.
Zhiyuan
Z
Shen
Department of Urology, Huadong Hospital, Fudan University, 221 West Yan'an Road, Shanghai, 200040, China. drzhongquan@sina.cn.
Zhongquan
Z
Sun
Bladder cancer; Cystectomy; Meta; Robot
Eur J Surg Oncol. 2014 Nov;40(11):1399-411
24767803
J Endourol. 2014 Oct;28(10):1215-23
25000311
Eur Urol. 2014 Feb;65(2):340-7
24183419
JSLS. 2015 Jan-Mar;19(1):e2014.00193
25848187
BJU Int. 2014 Mar;113(3):458-67
24053793
Eur Urol. 2015 Oct;68(4):721-8
25985883
BJU Int. 2013 Aug;112(4):E290-4
23815802
J Urol. 2013 Feb;189(2):474-9
23017529
Cancer Treat Rev. 2013 Oct;39(6):551-60
23273846
J Urol. 2010 Sep;184(3):990-4; quiz 1235
20643429
BJU Int. 2011 Sep;108(6):882-7
21166749
Eur Urol. 2014 Sep;66(3):569-76
24491306
PLoS One. 2015 Mar 31;10(3):e0121032
25825873
J Endourol. 2012 Jun;26(6):670-5
22011001
Eur Urol. 2010 Feb;57(2):196-201
19853987
J Endourol. 2011 Sep;25(9):1553-8
21834656
BMC Med Res Methodol. 2014 Dec 19;14:135
25524443
Int J Clin Pract. 2012 Jul;66(7):656-62
22507234
Arch Ital Urol Androl. 2015 Mar 31;87(1):41-8
25847896
CA Cancer J Clin. 2015 Jan-Feb;65(1):5-29
25559415
Urology. 2006 Feb;67(2):360-3
16461085
Ann Surg. 2004 Aug;240(2):205-13
15273542
Eur Urol. 2016 Apr;69(4):613-21
26272237
J Urol. 2010 Jul;184(1):87-91
20478596
BJU Int. 2003 Aug;92(3):232-6
12887473
Urology. 2012 Jun;79(6):1303-8
22516354
Urol Int. 2007;79(3):191-9
17940349
Eur Urol. 2015 Jun;67(6):1042-50
25496767