Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
BJU Int. 2013 Dec;112(8):1133-42. doi: 10.1111/bju.12255. Epub 2013 Aug 13.
To conduct a meta-analysis of the literature on the peri-operative outcomes of both robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN).
An electronic database search of MEDLINE, EMBASE, Google Scholar and the Cochrane Library was performed for publications up to 8 January 2013. All studies comparing RAPN with LPN were included. The outcome measures were demographic and peri-operative results, including operating time, warm ischaemia time, blood loss, length of hospital stay, conversion rates, positive surgical margins and complications. A meta-analysis of the results was conducted.
A total of 766 patients were included, 425 patients in the RAPN group and 341 patients in the LPN group. There was no significant difference between the two groups in any of the demographic variables (age: P = 0.89; sex: P = 0.31; malignant pathology: P = 0.54; tumour size: P = 0.99; tumour laterality: P = 0.06). There was no difference between the two groups regarding operating times (P = 0.75), estimated blood loss (P = 0.75), conversion rates (P = 0.52), positive surgical margins (P = 0.61), complications (P = 0.27) or length of hospital stay (P = 0.27), but the RAPN group had significantly shorter warm ischaemia times than the LPN group (P = 0.01; weighted mean difference: -3.65; 95% confidence interval, -6.46 to -0.83).
This meta-analysis shows that RAPN provides equivalent peri-operative outcomes to those of LPN, with the added advantage of a significantly shorter warm ischaemia time.
对机器人辅助部分肾切除术（RAPN）与腹腔镜部分肾切除术（LPN）的围手术期结果进行文献荟萃分析。
对 MEDLINE、EMBASE、Google Scholar 和 Cochrane 图书馆截至 2013 年 1 月 8 日的文献进行电子数据库检索，纳入比较 RAPN 与 LPN 的研究。观察指标为围手术期结果，包括手术时间、热缺血时间、出血量、住院时间、中转率、切缘阳性率和并发症。对结果进行荟萃分析。
共纳入 766 例患者，RAPN 组 425 例，LPN 组 341 例。两组患者的一般资料差异均无统计学意义（年龄：P = 0.89；性别：P = 0.31；恶性病理：P = 0.54；肿瘤大小：P = 0.99；肿瘤侧别：P = 0.06）。两组的手术时间（P = 0.75）、估计出血量（P = 0.75）、中转率（P = 0.52）、切缘阳性率（P = 0.61）、并发症（P = 0.27）或住院时间（P = 0.27）差异均无统计学意义，但 RAPN 组的热缺血时间显著短于 LPN 组（P = 0.01；加权均数差：-3.65；95%置信区间：-6.46 至-0.83）。
本荟萃分析表明，RAPN 与 LPN 的围手术期结果相当，且具有热缺血时间显著缩短的优势。
