Length of hospital stay and procedure time after partial nephrectomy or percutaneous thermal ablation: A systematic review and meta-analysis.

Introduction: This systematic review addressed the length of hospital stay (LOS) and procedure time in patients with small renal masses (SRM) undergoing open, conventional laparoscopic (OPN), and robot-assisted partial nephrectomy (RAPN), as well as percutaneous thermal ablation (PTA) in different geographic areas.

Methods: We conducted a comprehensive search in databases (MEDLINE, EMBASE, CINAHL) until July 2023, and we applied random-effect meta-analysis, with evidence certainty assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.

Results: We screened 3456 titles and abstracts, ultimately identifying 60 eligible studies. For the length of LOS (days) following OPN, our pooled estimates revealed means of 5.7 in North America, 7.1 in Europe, and 13.4 in Asia; following laparoscopic partial nephrectomy, means were 3.1, 5.4, and 5.8, respectively; for RAPN, means were 2.7, 3.8, and 7.1; and for PTA, means were 1.2, 1.6, and 1.6. Regarding procedure time (minutes) after OPN, means were 187 in North America, 132 in Europe, and 184 in Asia; after laparoscopic partial nephrectomy, means were 198, 127, and 200; after RAPN, means were 189, 150, and 192; and for PTA, mean was 144 in North America and no studies addressed procedure time in Europe and Asia.

Conclusions: Our study provides the most trustworthy available estimates of LOS and procedure time for patients undergoing invasive procedures for the management of SRM. These findings have emphasized the need for context-specific considerations when informing patients and making treatment decisions.