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Retroperitoneal or transperitoneal approach in robot-assisted partial nephrectomy, which one is better?

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机构: [1]Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, China. [2]Sichuan University, Chengdu, China. [3]Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
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关键词: partial nephrectomy retroperitoneal robotic surgical procedures transperitoneal

摘要:
To systematically assess the perioperative outcomes of retroperitoneal (RP) and transperitoneal (TP) approaches in robot-assisted partial nephrectomy (RAPN), we conducted an updated meta-analysis. A literature retrieval of multi-database including PubMed, Web of Science, Embase, Cochrane Library, and CNKI was performed to identify eligible comparative studies from the inception dates to January 2021. Perioperative outcomes included operative time (OT), estimated blood loss (EBL), warm ischemia time (WIT), postoperative length of stay (PLOS), positive surgical margin (PSM), and complications (major complications and overall complications). Outcomes of data were pooled and analyzed with Review Manager 5.4.1. Twenty-one studies involving a total of 2482 RP and 3423 TP approach RAPN patients met the inclusion criteria. Operating time (OT) (weighted mean difference [WMD] -16.60; 95% confidence interval [CI] -23.08, -10.12; p < 0.01) and PLOS (WMD -0.46 days; 95% CI -0.69, -0.23; p < 0.01) were shorter in RP-RAPN. Besides, lower EBL (WMD -21.67; 95% CI -29.74, -13.60; p < 0.05) was also found in RP-RAPN. Meanwhile, no significant differences were found in other outcomes. RP-RARN was superior to TP-RAPN in patients undergoing RAPN in terms of OT, PLOS, and estimated blood loss. Besides these two approaches have no significant differences in PSMs or perioperative complications. © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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出版当年[2021]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 肿瘤学
第一作者:
第一作者机构: [1]Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, China. [2]Sichuan University, Chengdu, China.
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通讯作者:
通讯机构: [3]Department of Urology, West China Hospital, Sichuan University, Chengdu, China. [*1]Department of Urology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan 610041, China.
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