Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou.
Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China.
Int J Surg. 2023 Sep 1;109(9):2808-2818. doi: 10.1097/JS9.0000000000000520.
To compare the safety and efficacy of robotic-assisted retroperitoneal lymph node dissection (RA-RPLND) versus non-robotic retroperitoneal lymph node dissection in testicular cancer.
The statistical analysis software used Stata 17. The weighted mean difference (WMD) represents the continuous variable, and the dichotomous variable chooses the odds ratio, and calculates the 95% CI. This systematic review and cumulative meta-analysis was performed according to PRISMA criteria, and AMSTAR guidelines (assessing the methodological quality of systematic reviews). The Embase, PubMed, Cochrane Library, Web of Science, and Scopus databases were searched. The upper limit of the search time frame was February 2023, and no lower limit was set.
Seven studies involving 862 patients. Compared with open retroperitoneal lymph node dissection, RA-RPLND appears to have a shorter length of stay [WMD=-1.21, 95% CI (-1.66, -0.76), P <0.05], less estimated blood loss [WMD=-0.69, 95% CI (-1.07, -0.32), P <0.05], and lower overall complications [odds ratio=0.45, 95% CI (0.28, 0.73), P <0.05]. RA-RPLND appears to have more lymph node yields than laparoscopic retroperitoneal lymph node dissection [WMD=5.73, 95% CI (1.06, 10.40), P <0.05]. However, robotic versus open/laparoscopic retroperitoneal lymph node dissection had similar results in operation time, lymph node positivity rate, recurrence during follow-up, and postoperative ejaculation disorders.
RA-RPLND appears to be safe and effective for testicular cancer, but longer follow-up and more studies are needed to confirm this.
比较机器人辅助腹膜后淋巴结清扫术（RA-RPLND）与非机器人腹膜后淋巴结清扫术治疗睾丸癌的安全性和疗效。
使用 Stata 17 统计分析软件。连续变量采用加权均数差（WMD）表示，二分类变量选择比值比（OR），计算 95%置信区间（CI）。本系统评价和累积荟萃分析按照 PRISMA 标准和 AMSTAR 指南（评估系统评价的方法学质量）进行。检索了 Embase、PubMed、Cochrane 图书馆、Web of Science 和 Scopus 数据库。搜索时间范围的上限为 2023 年 2 月，没有下限。
共纳入 7 项研究，涉及 862 例患者。与开放腹膜后淋巴结清扫术相比，RA-RPLND 似乎具有较短的住院时间[WMD=-1.21，95%CI（-1.66，-0.76），P<0.05]、较少的估计失血量[WMD=-0.69，95%CI（-1.07，-0.32），P<0.05]和较低的总体并发症发生率[OR=0.45，95%CI（0.28，0.73），P<0.05]。RA-RPLND 似乎比腹腔镜腹膜后淋巴结清扫术有更多的淋巴结产量[WMD=5.73，95%CI（1.06，10.40），P<0.05]。然而，机器人手术与开放/腹腔镜腹膜后淋巴结清扫术在手术时间、淋巴结阳性率、随访期间复发和术后射精障碍方面的结果相似。
RA-RPLND 似乎对睾丸癌安全有效，但需要更长的随访和更多的研究来证实这一点。
