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

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

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.

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).

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

International journal of surgery (London, England). 2021 Sep 29 [Epub ahead of print]

Naichun Zhou, Fengyan Tian, Yongjie Feng, Keyuan Zhao, Long Chen, Ruixin Fan, Wei Lu, Chaohui Gu

Department of Urology, Xinyang Central Hospital, Xinyang, 464000, China., Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China., Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China., Department of Urology, Xinyang Central Hospital, Xinyang, 464000, China. Electronic address: ., Department of Urology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China. Electronic address: .

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