Scholarlink

<p>As a novel surgical method for partial nephrectomy (PN), single-port robot-assisted partial nephrectomy (SP-RAPN) is becoming widely used. The efficacy and safety outcomes comparison between SP-RAPN and traditional multi-port RAPN (MP-RAPN) is still unclear. Hence, this study aims to compare the perioperative, oncological, and renal function outcomes between SP-RAPN and MP-RAPN based on updated evidence. A literature search was performed online in Web of Science, PubMed, Embase, Cochrane Library, and ClinicalTrials.gov, and eligible studies were selected based on the criteria. The quality assessment of the included studies was performed by using the revised Cochrane Collaboration Risk of Bias Tool for randomized-controlled studies and the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Effect sizes were calculated as odds ratios (ORs) for binary outcomes and as standard mean differences (SMDs) for continuous outcomes. All statistical analyses were conducted using Review Manager (version 5.4). 16 studies involving 2426 patients were finally analyzed. Compared to MP-RAPN, SP-RAPN shows lower off-clamp rate (OCR) (OR = 2.36, 95% confidence interval [CI]: 1.09, 5.12), less estimated blood loss (EBL) (SMD = -0.22, 95% CI: -0.38, -0.06), reduced length of hospital stay (SMD = -0.58, 95% CI: -0.91, -0.25), higher same-day discharge rate (OR = 3.62, 95% CI: 1.85, 7.09), lower positive surgical margin (OR = 0.67, 95% CI: 0.47, 0.96), and lower postoperative creatinine (SMD = -0.53, 95% CI: -0.86, -0.20). In addition, SP-RAPN has longer warm ischemia time (WIT) (SMD = 0.31, 95% CI: 0.07, 0.55) and less trifecta achievement (OR = 0.56, 95% CI: 0.34–0.97). No significant differences were found between operation time (OT), perioperative complications rate, intraoperative transfusion, intraoperative conversion, readmission after discharge, pain score, perioperative morphine milligram equivalent use, tumor recurrence rate, and other renal function outcomes. Large heterogeneity was found in OT, OCR, WIT, and EBL. As an alternative to MP-RAPN, SP-RAPN presents acceptable efficacy and safety. However, its influence on WIT, trifecta achievement, and renal function needs cautious assessment. More well-designed, prospective RCTs are vital to reinforce our findings.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Single-port versus multi-port robotic-assisted partial nephrectomy in perioperative, oncological, and renal function outcomes: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年4月2日

查看全文
  • Sike He,
  • Dingbang Liu,
  • Jinge Zhao,
  • Zhenhua Liu,
  • Ning Luo,
  • Bo Li,
  • Yaguang Wang,
  • Jinsong Zhang,
  • Hao Zeng,
  • Guangxi Sun

摘要

As a novel surgical method for partial nephrectomy (PN), single-port robot-assisted partial nephrectomy (SP-RAPN) is becoming widely used. The efficacy and safety outcomes comparison between SP-RAPN and traditional multi-port RAPN (MP-RAPN) is still unclear. Hence, this study aims to compare the perioperative, oncological, and renal function outcomes between SP-RAPN and MP-RAPN based on updated evidence. A literature search was performed online in Web of Science, PubMed, Embase, Cochrane Library, and ClinicalTrials.gov, and eligible studies were selected based on the criteria. The quality assessment of the included studies was performed by using the revised Cochrane Collaboration Risk of Bias Tool for randomized-controlled studies and the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Effect sizes were calculated as odds ratios (ORs) for binary outcomes and as standard mean differences (SMDs) for continuous outcomes. All statistical analyses were conducted using Review Manager (version 5.4). 16 studies involving 2426 patients were finally analyzed. Compared to MP-RAPN, SP-RAPN shows lower off-clamp rate (OCR) (OR = 2.36, 95% confidence interval [CI]: 1.09, 5.12), less estimated blood loss (EBL) (SMD = -0.22, 95% CI: -0.38, -0.06), reduced length of hospital stay (SMD = -0.58, 95% CI: -0.91, -0.25), higher same-day discharge rate (OR = 3.62, 95% CI: 1.85, 7.09), lower positive surgical margin (OR = 0.67, 95% CI: 0.47, 0.96), and lower postoperative creatinine (SMD = -0.53, 95% CI: -0.86, -0.20). In addition, SP-RAPN has longer warm ischemia time (WIT) (SMD = 0.31, 95% CI: 0.07, 0.55) and less trifecta achievement (OR = 0.56, 95% CI: 0.34–0.97). No significant differences were found between operation time (OT), perioperative complications rate, intraoperative transfusion, intraoperative conversion, readmission after discharge, pain score, perioperative morphine milligram equivalent use, tumor recurrence rate, and other renal function outcomes. Large heterogeneity was found in OT, OCR, WIT, and EBL. As an alternative to MP-RAPN, SP-RAPN presents acceptable efficacy and safety. However, its influence on WIT, trifecta achievement, and renal function needs cautious assessment. More well-designed, prospective RCTs are vital to reinforce our findings.