To evaluate the outcomes of robot-assisted partial nephrectomy (RAPN) for solid and cystic renal tumors. We systematically searched the Cochrane Library, PubMed, EMBASE, and Scopus databases up to March 2023. Review Manager 5.4 performed a pooled analysis of the data for random effects. Besides, sensitivity and subgroup analyses to explore heterogeneity, Newcastle-Ottawa scale, and GRADE to evaluate study quality and level of evidence. Five observational studies comprising 1353 patients (Cystic tumor: 183; Solid tumor: 1083) were included in this study. Compared to solid masses, cystic masses were associated with fewer major complications (odds ratio [OR] = 2.2; 95% confidence intervals [CI] = 1.17 to 4.13; p = 0.01). Additionally, no significant differences were observed between the two groups in terms of operative time, warm ischemia time, blood loss, hospital stay, intraoperative complications, postoperative complications, transfusion rate, postoperative estimated glomerular filtration rate (eGFR), eGFR preservation, positive surgical margin (PSM), recurrence, overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS) and trifecta achievement. RAPN can be performed in cystic renal tumors with perioperative, functional, and oncologic outcomes like those achievable in solid tumors. However, our findings need further validation in a large-sample prospective randomized study.
Asian journal of surgery. 2023 Aug 17 [Epub ahead of print]
Li Wang, Jing-Ya Deng, Kun-Peng Li, Shan Yin, Ping-Yu Zhu
Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China., Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China., Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China., Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China. Electronic address: .