Single-Port Versus Multiport Robot-Assisted Partial Nephrectomy: A Meta-Analysis.


Journal

Journal of endourology
ISSN: 1557-900X
Titre abrégé: J Endourol
Pays: United States
ID NLM: 8807503

Informations de publication

Date de publication:
07 Jan 2024
Historique:
medline: 8 1 2024
pubmed: 8 1 2024
entrez: 8 1 2024
Statut: aheadofprint

Résumé

Background Several centers have reported their experience with single-port robotic partial nephrectomy (SP-RAPN) however, it is uncertain if utilization of this platform represents an improvement in outcomes as compared to multiport robot-assisted partial nephrectomy (MP-RAPN). To evaluate this, we performed a meta-analysis to compare the perioperative, oncological, and functional outcomes between SP-RAPN and MP-RAPN. Methods For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until January 1, 2023. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. The odds ratio (OR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI). Results Of the 374 retrieved abstracts, eight studies were included in the final analysis, comprising a total cohort of 1,007 cases of robot-assisted partial nephrectomy (453 SP-RAPN cases and 554 MP-RAPN cases). Compared to MP-RARP, the SP-RAPN group had a significantly longer ischemia time (MD = 4.6 minutes, 95% CI 2.8 to 6.3, p<0.001), less estimated blood loss (MD = -12.4 mL, 95% CI -24.6 to -0.3, p=0.045), higher blood transfusion rate (OR = 2.97, 95% CI 1.33 to 6.65, p=0.008), and higher postoperative eGFR at 6 months (MD = 4.9 mL/min, 95% CI 0.2 to 9.7, p=0.04). There were no significant differences in other outcomes between the two approaches, including the intraoperative complication, minor postoperative complication (Clavien-Dindo I-II), major postoperative complication (Clavien-Dindo III-V), conversion to radical nephrectomy, pain score at day #1, pain score on discharge, morphine milligram equivalent (MME) usage, hospital stay, positive surgical margins and postoperative eGFR. Conclusions Initial studies have demonstrated that SP-RAPN is a safe and feasible approach to performing partial nephrectomy, albeit with inferior outcomes for ischemia time and blood transfusion rates.

Identifiants

pubmed: 38185840
doi: 10.1089/end.2023.0505
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Auteurs

Tuan Thanh Nguyen (TT)

University of Medicine and Pharmacy Ho Chi Minh City Faculty of Medicine, 305940, 217 Hong Bang Street, Ward 11, District 5 Ho Chi Minh City, Ho Chi Minh City, Viet Nam, 70000.
University of California Irvine, 8788, Urology, Irvine, United States, 92697; thanhtuan0131@gmail.com.

Xuan Thai Ngo (XT)

University of Medicine and Pharmacy at Ho Chi Minh City, Urology, Ho Chi Minh City, Viet Nam.
Cho Ray Hospital, 58601, Ho Chi Minh City, Viet Nam; ngoxuanthaidr@gmail.com.

Nguyen X Duong (NX)

University of Yamanashi - Graduate School of Medical Science Campus, 38147, Chuo, Yamanashi, Japan.
Cho Ray Hospital, 58601, Ho Chi Minh City, Ho Chi Minh, Viet Nam; dr.duongnguyenxuong@gmail.com.

Ryan W Dobbs (RW)

University of Pennsylvania Perelman School of Medicine, 14640, Surgery, 3400 Spruce Street, 4 Maloney, Philadelphia, Philadelphia, Pennsylvania, United States, 19104; ryanwdobbs@gmail.com.

Huy Gia Vuong (HG)

University of Iowa Hospitals and Clinics, 21782, Iowa City, Iowa, United States; huyvuong@hotmail.com.

David-Dan Nguyen (DD)

University of Toronto, 7938, Toronto, Ontario, Canada; daviddan.nguyen@mail.utoronto.ca.

Jacob Basilius (J)

University of California Irvine, 8788, Urology, Irvine, California, United States; jbasiliu@hs.uci.edu.

Narmina Khanmammadova (N)

University of California Irvine Medical Center, 21769, Urology, 3800 W Chapman Ave Suite 7200, Orange, California, United States, 92868-3298; nkhanmam@hs.uci.edu.

Dinno Francis Andaya Mendiola (DFA)

National Kidney and Transplant Institute, Urology, East Avenue, Quezon City, Philippines, 1101; dinnomendiola@gmail.com.

Tien-Dat Hoang (TD)

Cho Ray Hospital, 58601, Ho Chi Minh City, Viet Nam; dathoangmd@gmail.com.

Dang Nhat Minh Pham (DNM)

Pham Ngoc Thach University of Medicine, 384732, Ho Chi Minh, Ho Chi Minh, Viet Nam; phamdangnhatminh@gmail.com.

An Nguyen (A)

University of Medicine and Pharmacy Ho Chi Minh City Faculty of Medicine, 305940, Ho Chi Minh City, Viet Nam; npan.y19@ump.edu.vn.

Tuyet Mai Tran Thi (TM)

University of Medicine and Pharmacy Ho Chi Minh City Faculty of Medicine, 305940, Ho Chi Minh City, Viet Nam; dcromhead1042@gmail.com.

Sohrab Ali (S)

University of California Irvine, 8788, Urology, 3800 W Chapman Ave, Suite 7200, Irvine, California, United States, 92697; sohrabna@hs.uci.edu.

Mohammed Shahait (M)

University of Pittsburgh Medical Center, 6595, Urology , Kauffman Medical Building , 3471 fifth ave, Suite 700, Pennsylvania, Pittsburgh, Pennsylvania, United States, 15213-2582; mshahait@yahoo.com.

David I Lee (DI)

University of California Irvine, 8788, Urology, Irvine, California, United States; davidleegumd@yahoo.com.

Classifications MeSH