Division of HPB and Transplant Surgery, Department of Surgery, Erasmus MC Transplant Institute, Rotterdam, the Netherlands.
Int J Surg. 2022 Mar;99:106264. doi: 10.1016/j.ijsu.2022.106264. Epub 2022 Feb 17.
Robot-assisted kidney transplantation (RAKT) has emerged as an alternative for kidney transplant recipients with the potential benefits of minimally invasive surgery. The aim of this systematic review and meta-analysis is to compare the clinical outcomes of RAKT with open kidney transplantation (OKT).
MEDLINE, Embase, Web of Science and Cochrane databases were systematically searched. Baseline characteristics, intraoperative and postoperative outcomes were collected, as well as long-term renal function and data on graft and patient survival.
Eleven studies were included, which compared 482 RAKT procedures with 1316 OKT procedures. RAKT was associated with lower a risk of surgical site infection (Risk ratio (RR) = 0.15, p < 0.001), symptomatic lymphocele (RR = 0.20, p = 0.03), less postoperative pain (Mean difference (MD) = -1.38 points, p < 0.001), smaller incision length (MD = -8.51 cm, p < 0.001), and shorter length of hospital stay (MD = -1.69 days, p = 0.03) compared with OKT. No difference was found in renal function, graft, and patient survival.
RAKT is a safe and feasible alternative to OKT with less surgical complications without compromising renal function, graft and patient survival.
机器人辅助肾移植(RAKT)已成为肾移植受者的一种替代方法,具有微创手术的潜在优势。本系统评价和荟萃分析的目的是比较 RAKT 与开放肾移植(OKT)的临床结果。
系统检索 MEDLINE、Embase、Web of Science 和 Cochrane 数据库。收集基线特征、围手术期结果以及长期肾功能和移植物及患者生存数据。
纳入了 11 项研究,比较了 482 例 RAKT 与 1316 例 OKT。RAKT 与手术部位感染风险降低相关(风险比(RR)=0.15,p<0.001)、症状性淋巴囊肿(RR=0.20,p=0.03)、术后疼痛减轻(平均差值(MD)=-1.38 分,p<0.001)、切口长度较小(MD=-8.51 厘米,p<0.001)和住院时间较短(MD=-1.69 天,p=0.03)。在肾功能、移植物和患者存活率方面没有差异。
RAKT 是 OKT 的一种安全可行的替代方法,具有较少的手术并发症,而不会影响肾功能、移植物和患者的存活率。