Perioperative outcomes of intracorporeal robot-assisted radical cystectomy versus open radical cystectomy: A systematic review and meta-analysis of comparative studies.

Abstract

PURPOSE:

To systematically review studies comparing the perioperative outcomes of intracorporeal robot-assisted radical cystectomy (iRARC) and open radical cystectomy (ORC).

METHODS:

Systematic searches of PubMed, Web of Science and the Cochrane Library were performed in June 2020. Studies with data comparing iRARC and ORC were included in our review, and a pooled meta-analysis was completed.

RESULTS:

In total, 8 studies (7 prospective studies, 1 retrospective study) comparing 1193 patients were included for our review and meta-analysis. Compared with ORC, iRARC demonstrated lower estimated blood loss (weighted mean difference (WMD): -449.25; 95% CI -566.47 - -332.03; p < 0.01), lower blood transfusion rates (OR: 0.31; 95% CI 0.22 - 0.46; p < 0.01), and lower postoperative complication rates with Clavien-Dindo grades III-IV (30 days: OR: 0.65; 95% CI 0.47 - 0.90; p = 0.01; 90 days: OR: 0.72; 95% CI 0.53 - 0.98; p = 0.04), but a longer operative time (WMD: 78.82; 95% CI 52.77 - 104.87; P < 0.01). Furthermore, there was no significant difference between iRARC and ORC in terms of postoperative complication rates with Clavien-Dindo grades Ⅰ-Ⅱ (30 days: OR: 0.71; 95% CI 0.36 - 1.40; p = 0.32; 90 days: OR: 0.98; 95% CI 0.74 - 1.30; p = 0.89), length of stay (WMD: -1.18; 95% CI -3.33 - -2.07; p = 0.06) and positive surgical margins (OR: 0.78; 95% CI 0.0.45 - 1.36; p = 0.38).

CONCLUSION:

iRARC was associated with a significantly lower estimated blood loss and a lower blood transfusion rate and major postoperative complication rate than ORC.

• Authors: Naichun Zhou, Fengyan Tian, Yongjie Feng, Keyuan Zhao, Long Chen, Ruixin Fan, Wei Lu, Chaohui Gu
• Journal: International journal of surgery (London, England) (Int J Surg) Vol. 94 Pg. 106137 (Oct 2021) ISSN: 1743-9159 [Electronic] England
• PMID: 34600124 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: Copyright © 2021 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Topics

• Cystectomy (adverse effects)
• Humans
• Postoperative Complications (epidemiology, etiology)
• Prospective Studies
• Retrospective Studies
• Robotic Surgical Procedures (adverse effects)
• Robotics
• Treatment Outcome
• Urinary Bladder Neoplasms (surgery)