Rong Ruo-Zeng, Zhang Pan, Zhao Mei, He Cui-E
Department of Urology, Zibo Central Hospital, Zibo, 255036, Shandong Province, China.
Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
J Robot Surg. 2025 Jan 29;19(1):56. doi: 10.1007/s11701-025-02217-4.
The main aim of this meta-analysis is to assess and compare the impact of two different surgical approaches, transperitoneal and retroperitoneal, on perioperative outcomes in robotic partial nephrectomy. A systematic search of MEDLINE, PubMed, Google Scholar, and the Cochrane Database was conducted to identify relevant studies published between January 2000 and January 2025. Included were nine non-randomized controlled trials with a total of 2420 patients with matching propensity scores. Among these patients, 1321 had robotic TPPN and 1099 had robotic RPPN, the abbreviation for robotic partial nephrectomy. Shorter operating times, shorter hospital stays, less estimated intraoperative blood loss, and fewer total postoperative problems were related to RPPN compared to TPPN. There were no notable disparities between the two groups when comparing the duration of renal ischemia, the fall in postoperative glomerular filtration rate (GFR), the occurrence of serious postoperative sequelae, or the necessity for blood transfusions. Compared to TPPN, RPPN demonstrates certain advantages in perioperative metrics such as surgical time, hospital stay, and overall complication rates. However, further high-quality studies are needed to confirm these findings.
本荟萃分析的主要目的是评估和比较经腹腔和腹膜后两种不同手术入路对机器人辅助部分肾切除术围手术期结局的影响。我们对MEDLINE、PubMed、谷歌学术和考克兰数据库进行了系统检索，以确定2000年1月至2025年1月期间发表的相关研究。纳入了9项非随机对照试验，共有2420例倾向评分匹配的患者。在这些患者中，1321例行机器人辅助经腹腔部分肾切除术（TPPN），1099例行机器人辅助腹膜后部分肾切除术（RPPN，机器人辅助部分肾切除术的缩写）。与TPPN相比，RPPN的手术时间更短、住院时间更短、估计术中失血量更少、术后总问题更少。在比较肾缺血时间、术后肾小球滤过率（GFR）下降、严重术后后遗症的发生或输血必要性时，两组之间没有显著差异。与TPPN相比，RPPN在手术时间、住院时间和总体并发症发生率等围手术期指标方面表现出一定优势。然而，需要进一步的高质量研究来证实这些发现。
