Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
J Robot Surg. 2022 Oct;16(5):1229-1232. doi: 10.1007/s11701-021-01365-7. Epub 2022 Jan 8.
In Japan, the robot-assisted partial nephrectomy (RAPN) started to be covered by health insurance since 2016, and it is replacing conventional open partial nephrectomy (OPN). RAPN is a minimally invasive surgery, and the spreading of RAPN in partial nephrectomy (PN) performed annually is expected to reduce the number of blood transfusions in Japan. The number of PN surgery in Japan was calculated using the Japanese NDB open data in 2018. We extracted articles comparing the transfusion rates of RAPN and OPN from 2017 to 2021 using PubMed, Web of Science, and Ichu-shi, and integrated the ratios of transfusion rates by meta-analysis. We estimated the reduction in the annual transfusion cases in PN due to the widespread use of RAPN. The total number of renal cancer surgeries in 2018 was 21,298, of which 3,876 (18.2%) were RAPN and 4,384 (20.6%) were OPN. For the comparison of transfusion implementation rate between RAPN and OPN, 871 articles were screened and 27 articles were included. The pooled ratio in transfusion rate of RAPN compared with OPN was 0.49 [0.46, 0.52]; the introduction of RAPN was estimated to have reduced the annual number of transfusions in PN by 9.1% compared with that of unintroduced RAPN. This study showed quantitatively evaluated the impact of the introduction of RAPN on the decrease in the annual number of transfusions in Japan. This method has the potential to evaluate the impact of robot-assisted surgery on the use of blood products for transfusion.
在日本，机器人辅助部分肾切除术（RAPN）自 2016 年开始纳入医疗保险，并且正在取代传统的开放部分肾切除术（OPN）。RAPN 是一种微创手术，预计每年进行的 RAPN 在部分肾切除术（PN）中的普及将减少日本的输血数量。2018 年，我们使用日本 NDB 开放数据计算了日本的 PN 手术数量。我们使用 PubMed、Web of Science 和 Ichu-shi 从 2017 年到 2021 年提取了比较 RAPN 和 OPN 输血率的文章，并通过荟萃分析整合了输血率的比值。我们估计由于 RAPN 的广泛使用，PN 每年输血病例数的减少。2018 年肾癌手术总数为 21298 例，其中 3876 例（18.2%）为 RAPN，4384 例（20.6%）为 OPN。为了比较 RAPN 和 OPN 之间的输血实施率，筛选了 871 篇文章，纳入了 27 篇文章。RAPN 输血率与 OPN 相比的合并比值为 0.49[0.46，0.52]；与未引入 RAPN 相比，引入 RAPN 估计将使 PN 每年的输血次数减少 9.1%。本研究定量评估了 RAPN 的引入对日本每年输血次数减少的影响。这种方法有可能评估机器人辅助手术对输血用血液制品使用的影响。
