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. 2014 Sep 18:14:75.
doi: 10.1186/1471-2490-14-75.

Robotic radical nephrectomy for renal cell carcinoma: a systematic review

Anastasios D Asimakopoulos  1 , Roberto Miano, Filippo Annino, Salvatore Micali, Enrico Spera, Beniamino Iorio, Giuseppe Vespasiani, Richard Gaston
Affiliations

Robotic radical nephrectomy for renal cell carcinoma: a systematic review

Anastasios D Asimakopoulos et al. BMC Urol. .

Abstract

Background: Laparoscopic radical nephrectomy (LRN) is the actual gold-standard for the treatment of clinically localized renal cell carcinoma (RCC) (cT1-2 with no indications for nephron-sparing surgery). Limited evidence is currently available on the role of robotics in the field of radical nephrectomy. The aim of the current study was to provide a systematic review of the current evidence on the role of robotic radical nephrectomy (RRN) and to analyze the comparative studies between RRN and open nephrectomy (ON)/LRN.

Methods: A Medline search was performed between 2000-2013 with the terms "robotic radical nephrectomy", "robot-assisted laparoscopic nephrectomy", "radical nephrectomy". Six RRN case-series and four comparative studies between RRN and (ON)/pure or hand-assisted LRN were identified.

Results: Current literature produces a low level of evidence for RRN in the treatment of RCC, with only one prospective study available. Mean operative time (OT) ranges between 127.8-345 min, mean estimated blood loss (EBL) ranges between 100-273.6 ml, and mean hospital stay (HS) ranges between 1.2-4.3 days. The comparison between RRN and LRN showed no differences in the evaluated outcomes except for a longer OT for RRN as evidenced in two studies. Significantly higher direct costs and costs of the disposable instruments were also observed for RRN. The comparison between RRN and ON showed that ON is characterized by shorter OT but higher EBL, higher need of postoperative analgesics and longer HS.

Conclusions: No advantage of robotics over standard laparoscopy for the treatment of clinically localized RCC was evidenced. Promising preliminary results on oncologic efficacy of RRN have been published on the T3a-b disease. Fields of wider application of robotics should be researched where indications for open surgery still persist.

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Figure 1
Figure 1
Flow of information through the different phases of this systematic review, according to the PRISMA Flow Diagram ( http://www.prisma-statement.org/statement.htm ).
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References

    1. http://seer.cancer.gov/statfacts/html/kidrp.html.
    1. Ljungberg B, Cowan NC, Hanbury DC, Hora M, Kuczyk MA, Merseburger AS, Patard JJ, Mulders PF, Sinescu IC. EAU guidelines on renal cell carcinoma: the 2010 update. Eur Urol. 2010;58(3):398–406. doi: 10.1016/j.eururo.2010.06.032. - DOI - PubMed
    1. Klingler DW, Hemstreet GP, Balaji KC. Feasibility of robotic radical nephrectomy—initial results of single-institution pilot study. Urology. 2005;65(6):1086–1089. doi: 10.1016/j.urology.2004.12.020. - DOI - PubMed
    1. Gill IS, Sung GT, Hsu TH, Meraney AM. Robotic remote laparoscopic nephrectomy and adrenalectomy: the initial experience. J Urol. 2000;164(6):2082–2085. doi: 10.1016/S0022-5347(05)66973-X. - DOI - PubMed
    1. Guillonneau B, Jayet C, Tewari A, Vallancien G. Robot assisted laparoscopic nephrectomy. J Urol. 2001;166(1):200–201. doi: 10.1016/S0022-5347(05)66111-3. - DOI - PubMed

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