Evaluation of robotic and laparoscopic partial nephrectomy for small renal tumours (T1a). (11th March 2013)

• Record Type: Journal Article
• Authors: Froghi, Saied; Ahmed, Kamran; Khan, Mohammad S.; Dasgupta, Prokar; Challacombe, Ben
• Is Part Of: BJU international. Volume 112:Number 4(2013:Aug.)
• Page Start: E322
• Page End: E333
• Publication Date: 2013-03-11
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12053
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12053-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12053-list-0001" list-type="bullet"> <list-item> <p>To compare laparoscopic partial nephrectomy (LPN) with robotic PN (RPN) using meta‐analytical techniques, since there has been a rise in the incidence of small renal masses (SRM; <4 cm) minimally invasive approaches are becoming more popular in dealing with such pathologies.</p> </list-item> </list> </p> </sec> <sec id="bju12053-sec-0002" sec-type="section"> <title>Materials and Methods</title> <p> <list id="bju12053-list-0002" list-type="bullet"> <list-item> <p>A systematic review of the literature was performed to identify studies comparing LPN and RPN.</p> </list-item> <list-item> <p>Comparative studies evaluating RPN and LPN that fulfilled the inclusion criteria were selected.</p> </list-item> <list-item> <p>Data on preoperative, operative (operative time, estimated blood loss [EBL], and warm ischaemia time [WIT]), postoperative (length of stay [LOS]) variables and complications were collected.</p> </list-item> <list-item> <p>A meta‐analysis using random effect model was performed.</p> </list-item> <list-item> <p>A further Bland–Altman analysis of some of the operative variables was done to compare their reproducibility and mean difference in techniques.</p> </list-item> </list> </p> </sec> <sec id="bju12053-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12053-list-0003" list-type="bullet"> <list-item> <p>Six studies matched the selection criteria. In all, 256 patients were analysed (40% RPN and 60% LPN).</p> </list-item> <list-item> <p>There was no significant different in EBL (<italic>P</italic> = 0.12, 95% confidence interval [CI] –12.01 to 104.26).</p> </list-item> <list-item> <p>Similarly, there was no significant different in WIT between the groups (<italic>P</italic> = 0.23, 95% CI –15.22 to 3.70).</p> </list-item> <list-item> <p>Also, LOS (<italic>P</italic> = 0.22, 95% CI –0.38 to 0.09) and overall postoperative complication rates were not significantly different between the groups (<italic>P</italic> = 0.84, 95% CI –0.05 to 0.06).</p> </list-item> </list> </p> </sec> <sec id="bju12053-sec-0004" sec-type="section"> <title>Conclusions</title> <p> <list id="bju12053-list-0004" list-type="bullet"> <list-item> <p>Despite multiple studies reporting better perioperative variables for RPN, the present study found no significant differences between RPN and LPN. This has implications for both the surgeon and the patient.</p> </list-item> <list-item> <p>Lack of randomised controlled trials in addition to a lack of long‐term oncological data for RPN are current limitations.</p> </list-item> </list> </p> </sec> </abstract>