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Comparison of Perioperative Outcomes and Complications of Laparoscopic and Robotic Nephroureterectomy Approaches in Patients with Upper-Tract Urothelial Carcinoma

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

For medical institutions without robotic equipment, it remains uncertain whether laparoscopic radical nephroureterectomy (LNU) can achieve results similar to those of robotic surgery for the treatment of upper tract urothelial carcinoma (UTUC). This meta-analysis aimed to compare the efficacy and safety of robot-assisted radical nephroureterectomy (RANU) with that of LNU using a large sample size of patients.

Methods

A systematic meta-analysis was performed using data (available to May 2022) acquired from multiple scientific databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Assessing the Methodological Quality of Systematic Reviews (AMSTAR) guidelines, according to the protocols registered with PROSPERO (CRD42021264046), were followed to perform this cumulative analysis.

Results

Nine high-quality studies were included in this analysis, considering factors such as operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), positive surgical margins (PSM), and complications. Statistical indicators revealed no significant differences between the RANU and LNU groups in terms of OT (weighted mean difference [WMD] 29.41, 95% confidence interval [CI] −1.10 to 59.92; p = 0.22), EBL (WMD −55.30, 95% CI −171.14 to 60.54; p = 0.13), LOS (WMD −0.39, 95% CI −1.03 to 0.25; p = 0.12), PSM (odds ratio [OR] 1.22, 95% CI 0.44–3.36; p = 0.17], or complications (OR 0.91, 95% CI 0.49–1.69; p = 0.13).

Conclusion

The meta-analysis showed that the perioperative and safety indicators of both RANU and LNU were similar and both showed favorable outcomes in UTUC treatment. However, some uncertainties remain in the implementation and selection of lymph nodes for dissection.

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Acknowledgment

The authors thank Mrs. Xinnan Gou for providing continual encouragement to Dr. Lei Peng in his medical career.

Funding

This work was supported by the Sichuan Province Science and Technology Planning Project under grant number 2020YFS0320, and Sichuan Provincial Health Committee Research Project under grant number 20PJ305.

Author information

Author notes

  1. Lei Peng, Irfan Mehmud, Chunyang Meng, and Dongdong Tang contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, The Second Hospital of Lanzhou University Medical School, Lanzhou, Gansu, China

    Lei Peng PhD & Dongdong Tang PhD

  2. Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China

    Lei Peng PhD, Chunyang Meng MM, Kangsen Li MM, Lijian Gan MM & Yunxiang Li PhD

  3. Department of Urology, The Third Affiliated Hospital of Shenzhen University (Luohu Hospital Group), Shenzhen University, Shenzhen, China

    Lei Peng PhD, Irfan Mehmud PhD & Dongdong Tang PhD

  4. South China Hospital, Health Science Center, Shenzhen University, Shenzhen, China

    Lei Peng PhD, Irfan Mehmud PhD & Dongdong Tang PhD

  5. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China

    Jinze Li PhD

  6. North Sichuan Medical College (University), Nanchong, Sichuan, China

    Fulin Yi MM

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Correspondence to Yunxiang Li PhD.

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Disclosure

Lei Peng, Irfan Mehmud, Chunyang Meng, Dongdong Tang, Kangsen Li, Lijian Gan, Jinze Li, Fulin Yi, and Yunxiang Li have no conflicts of interest to declare in relation to this work.

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Peng, L., Mehmud, I., Meng, C. et al. Comparison of Perioperative Outcomes and Complications of Laparoscopic and Robotic Nephroureterectomy Approaches in Patients with Upper-Tract Urothelial Carcinoma. Ann Surg Oncol 30, 3805–3816 (2023). https://doi.org/10.1245/s10434-023-13221-z

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