Is Cryotherapy a Genuine Rival to Robotic Assisted Partial Nephrectomy in the Management of Suspected Renal Malignancy? a Systematic Review and Meta-Analysis

We systematically reviewed world literature and compare oncological outcomes, morbidity, renal function and peri-operative outcome between cryotherapy (CA) and robotic assisted partial nephrectomy (RAPN) for suspected renal malignancy. There was a statistically significant difference for "recurrence rates" between the 2 techniques, favouring the RAPN cohort. There was no statistically significant difference in overall and ≥Clavien 3a complication rates between the 2 techniques. The quality of evidence for recurrence rates, overall complication and ≥Clavien 3a were 'moderate', 'low' and 'very low' respectively on GRADE approach. If a nephron sparing approach is indicated, RAPN should be the approach of choice.

Urology. 2017 Sep 26 [Epub ahead of print]

Bhavan Prasad Rai, Patrick Jones, Campbell Tait, Ramachandran Amitharaj, Raj Gowda, Aftab Bhatti, Jim Adshead, Bhaskar Somani

James Cook University Hospital, Department of Urology, Middlesbrough, UK. Electronic address: ., Royal Preston Hospital, Department of Urology, Preston, UK., James Cook University Hospital, Department of Urology, Middlesbrough, UK., County Durham & Darlington NHS Foundation Trust, UK., Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK., Associate Professor and Consultant Urological Surgeon, University Hospital Southampton NHS Trust, Southampton, UK.