#1207

Impact of Robot-Assisted Versus Laparoscopic Approaches on Perioperative Outcomes in Partial Nephrectomy: A Systematic Review and Meta-Analysis

M. Putra¹, K. Penta Seputra¹, T. Nur Budaya¹

¹Faculty of Medicine, University of Brawijaya, Urology Department, Malang, Indonesia

Introduction:

Partial nephrectomy (PN) is the standard treatment for small renal tumors due to its nephron-sparing advantages. Robot-assisted partial nephrectomy (RAPN) and laparoscopic partial nephrectomy (LPN) are two minimally invasive approaches increasingly utilized for PN. However, there remains ongoing controversy regarding their perioperative outcomes. This meta-analysis aims to compare perioperative outcomes between RAPN and LPN in partial nephrectomy

Material and methods:

Data collected from PubMed, Google Scholar, and ScienceDirect from 2000 to January 20, 2025. The inclusion criteria for this meta-analysis were randomized controlled trials (RCTs) and cohort studies comparing RAPN with LPN in adult patients undergoing partial nephrectomy for renal tumors. Studies that reported on perioperative outcomes, including estimated blood loss (EBL) and warm ischemic time. The exclusion criteria consisted of studies that were not in English, those that could not be downloaded, or those lacking relevant perioperative data. Two independent reviewers conducted data extraction and assessed study quality using the Newcastle-Ottawa quality scale for observational studies. The meta-analysis was performed following the PRISMA guidelines to ensure transparency and minimize bias.

Results:

There were 3801 journals screened and twenty-seven studies were eligible for systematic review and nineteen studies of them for meta-analysis with a total of 3657 patients. Meta-analysis showed that RAPN favored lower mean blood loss (MD = 19.00, 95% CI [11.09, 26.92], p < 0.0001), while LPN showed a shorter warm ischemic time (MD = -5.64, 95% CI [-5.94, -5.34], p < 0.0001). These findings suggest that RAPN is associated with less blood loss, while LPN might offer a slight advantage in terms of ischemic time. Limitation this study is didn’t compare the post operative kidney function.