Comparison of Therapeutic Effects Among Different Surgical Approaches in Robot-Assisted Partial Nephrectomy: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Shengdong Ge ◽  
Lidong Chen ◽  
Sheng Tai
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Surgical Approaches ◽  
Therapeutic Effects ◽  
Robot Assisted

On-clamp versus off-clamp robotic partial nephrectomy: A systematic review and meta-analysis

2019 ◽  
Vol 86 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Alessandro Antonelli ◽  
Alessandro Veccia ◽  
Simone Francavilla ◽  
Riccardo Bertolo ◽  
Pierluigi Bove ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Partial Nephrectomy ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Robotic Partial Nephrectomy ◽  
Weighted Mean ◽  
Robot Assisted ◽  
Significant Difference

Background: The debate on the pros and cons of robot-assisted partial nephrectomy performed with (on-clamp) or without (off-clamp) renal artery clamping is ongoing. The aim of this meta-analysis is to summarize the available evidence on the comparative studies assessing the outcomes of these two approaches. Material and methods: A systematic review of the literature on PubMed, ScienceDirect®, and Embase® was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA). Only comparative and case-control studies were submitted to full-text assessment and meta-analysis. RevMan 5.3 software was used. Results: From the initial retrieval of 1937 studies, 15 fulfilling inclusion criteria were selected and provided 2075 patients for analysis (702 off-clamp, 1373 on-clamp). Baseline tumor’s features showed a significant difference in size (weighted mean difference: –0.58 cm; 95% confidence interval: [–1.06, –0.10]; p = 0.02) and R.E.N.A.L. score (weighted mean difference: –0.53; 95% confidence interval: [–0.81, –0.25]; p = 0.0002), but not in the exophytic property, the location, and the PADUA score. Pooled analysis revealed shorter operative time (p = 0.02) and higher estimated blood loss (p = 0.0002) for the off-clamp group. Overall complication and transfusion rates were similar, while higher major complication rate was observed in the on-clamp approach (5.6% vs 1.9%, p = 0.03). No differences in oncological outcomes were found. Finally, functional outcomes (assessed by estimated glomerular filtration rate at early postoperative, 3 month, 6 month, and last available follow-up) were not statistically different. Conclusion: This meta-analysis shows that off-clamp robot-assisted partial nephrectomy is reserved to smaller renal masses. Under such conditions, no differences with the on-clamp approach emerged.

scholarly journals Transperitoneal versus retroperitoneal robot-assisted partial nephrectomy: A systematic review and meta-analysis

2016 ◽  
Vol 30 ◽  
pp. 109-115 ◽  
Author(s):  
Leilei Xia ◽  
Xiaohua Zhang ◽  
Xianjin Wang ◽  
Tianyuan Xu ◽  
Liang Qin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Meta Analysis ◽  
Robot Assisted

Prevalence of Benign Pathology after Partial Nephrectomy for Suspected Renal Tumor: A Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Jae Heon Kim ◽  
Sung Ryul Shim ◽  
Hyun Young Lee ◽  
Jae Joon Park ◽  
Yash Khandwala ◽  
...  
Keyword(s):  
Systematic Review ◽  
Partial Nephrectomy ◽  
Renal Tumor ◽  
Meta Analysis ◽  
Benign Pathology
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