Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 20:13:1178592.
doi: 10.3389/fonc.2023.1178592. eCollection 2023.

Perioperative, oncologic, and functional outcomes of robot-assisted partial nephrectomy for special types of renal tumors (hilar, endophytic, or cystic): an evidence-based analysis of comparative outcomes

Xiao-Bin Chen  1 , Yu-Gen Li  1 , Tao Wu  2 , Zhong-Bo Du  2 , Chun-Lin Tan  1 , Qiang Zhang  1 , Xiao-Dong Yu  1   2
Affiliations

Perioperative, oncologic, and functional outcomes of robot-assisted partial nephrectomy for special types of renal tumors (hilar, endophytic, or cystic): an evidence-based analysis of comparative outcomes

Xiao-Bin Chen et al. Front Oncol. .

Abstract

Purpose: This study aims to perform a pooled analysis to compare the outcomes of robot-assisted partial nephrectomy (RAPN) between complex tumors (hilar, endophytic, or cystic) and non-complex tumors (nonhilar, exophytic, or solid) and evaluate the effects of renal tumor complexity on outcomes in patients undergoing RAPN.

Methods: Four databases were systematically searched, including Science, PubMed, Web of Science, and Cochrane Library, to identify relevant studies published in English up to December 2022. Review Manager 5.4 was used for statistical analyses and calculations. The study was registered with PROSPERO (Registration number: CRD42023394792).

Results: In total, 14 comparative trials, including 3758 patients were enrolled. Compared to non-complex tumors, complex tumors were associated with a significantly longer warm ischemia time (WMD 3.67 min, 95% CI 1.78, 5.57; p = 0.0001), more blood loss (WMD 22.84 mL, 95% CI 2.31, 43.37; p = 0.03), and a higher rate of major complications (OR 2.35, 95% CI 1.50, 3.67; p = 0.0002). However, no statistically significant differences were found between the two groups in operative time, length of stay, transfusion rates, conversion to open nephrectomy and radical nephrectomy rates, estimated glomerular filtration rate (eGFR) decline, intraoperative complication, overall complication, positive surgical margins (PSM), local recurrence, and trifecta achievement.

Conclusions: RAPN can be a safe and effective procedure for complex tumors (hilar, endophytic, or cystic) and provides comparable functional and oncologic outcomes to non-complex tumors.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=394792, identifier CRD42023394792.

Keywords: cystic renal tumors; endophytic renal tumors; meta-analysis; renal hilar tumors; robot-assisted partial nephrectomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram for the systematic review.
Figure 2
Figure 2
Forest plots of perioperative outcome- operative time.
Figure 3
Figure 3
Forest plots of perioperative outcome- warm ischemia time.
Figure 4
Figure 4
Forest plots of perioperative outcome-blood loss.
Figure 5
Figure 5
Forest plots of complication- major complications.
Figure 6
Figure 6
Forest plots of complication- overall complications.
Figure 7
Figure 7
Forest plots of renal functional outcome- eGFR decline.
Figure 8
Figure 8
Forest plots of oncologic outcome-PSM.
Figure 9
Figure 9
Funnel plot of oncologic outcomes (A) recurrence, (B) trifecta achievement.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Campbell S, Uzzo RG, Allaf ME, Bass EB, Cadeddu JA, Chang A, et al. . Renal mass and localized renal cancer: AUA guideline. J Urol (2017) 198(3):520–9. doi: 10.1016/j.juro.2017.04.100 - DOI - PubMed
    1. Ljungberg B, Cowan NC, Hanbury DC, Hora M, Kuczyk MA, Merseburger AS, et al. . 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. Wang J, Lu Y, Wu G, Wang T, Wang Y, Zhao H, et al. . The role of three-dimensional reconstruction in laparoscopic partial nephrectomy for complex renal tumors. World J Surg Oncol (2019) 17(1):159. doi: 10.1186/s12957-019-1701-x - DOI - PMC - PubMed
    1. Chang KD, Abdel Raheem A, Kim KH, Oh CK, Park SY, Kim YS, et al. . Functional and oncological outcomes of open, laparoscopic and robot-assisted partial nephrectomy: a multicentre comparative matched-pair analyses with a median of 5 years' follow-up. BJU Int (2018) 122(4):618–26. doi: 10.1111/bju.14250 - DOI - PubMed
    1. Choi JE, You JH, Kim DK, Rha KH, Lee SH. Comparison of perioperative outcomes between robotic and laparoscopic partial nephrectomy: a systematic review and meta-analysis. Eur Urol (2015) 67(5):891–901. doi: 10.1016/j.eururo.2014.12.028 - DOI - PubMed

Publication types