{"title":"机器人辅助与开放式部分肾切除术治疗肾恶性肿瘤的比较，重点是肿瘤预后：文献的系统回顾和荟萃分析","authors":"Diomidis Kozyrakis, Chara Tzavara, Christos Damaskos, Anastasios Zarkadas, Dimitrios Bozios, Athanasios Karmogiannis, Vasileios Konstantinopoulos, Georgios Haronis, Anna-Maria Konomi, Georgios Kallinikas, Konstantinos Safioleas, Athanasios Filios, Despoina Mytiliniou, Evangelos Rodinos, Panagiotis Filios, Dimitrios Dimitroulis","doi":"10.1007/s11934-025-01282-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Robotic assisted partial nephrectomy (RaPN) is the treatment of choice for small and resectable renal tumors offering better results in terms of blood loss, postoperative complications and length of hospital stay compared with the open partial nephrectomy (OPN), while for both techniques the risk of postoperative renal dysfunction is limited. However, the oncologic outcomes of the robotic procedure are yet to be determined. Therefore, a comprehensive research of PubMed/Medline, Embase and Scopus databases from the year 2000 till June 2024 was performed to elucidate the results related to oncologic outcomes. The ROBINS-I tool for non-randomized cohort studies was applied for the assessment of the quality of the included studies. All statistical analyses were performed with the use of STATA software version 15.0.</p><p><strong>Recent findings: </strong>The study was registered in International Platform of Registered Systematic Review and Metaanalysis Protocols database with the registration number INPLASY202450054. Overall 11 studies with 4758 patients were included in the present systematic review and meta-analysis. No statistically significant difference between the two treatment methods was reconded for the outcomes of overall survival [HR: 1.23 (95% CI: 0.68, 2.20)- p = 0.488], disease-specific survival [OR: 2.53 (95% CI: 0.65, 9.78)- p = 0.179], progression-free survival [HR: 1.04 (95% CI: 0.60, 1.79)- p = 0.901], recurrence-free survival [HR: 0.83 (95% CI = 0.54, 1.27)-p = 0.394] and disease-free survival [OR: 1.01 (95% CI = 0.98, 1.03)-p = 0.582]. The quality of most of the included studies was deemed moderate. Despite the need for more high quality comparative studies it is assumed that these results could be helpful in decision making and in counselling patients with resectable renal tumors to whom a nephron sparing surgery may be considered.</p>","PeriodicalId":11112,"journal":{"name":"Current Urology Reports","volume":"26 1","pages":"53"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Robot-Assisted Versus Open Partial Nephrectomy for Treating Renal Malignancies With An Emphasis on Oncological Outcomes: A Systematic Review and Meta-Analysis of The Literature.\",\"authors\":\"Diomidis Kozyrakis, Chara Tzavara, Christos Damaskos, Anastasios Zarkadas, Dimitrios Bozios, Athanasios Karmogiannis, Vasileios Konstantinopoulos, Georgios Haronis, Anna-Maria Konomi, Georgios Kallinikas, Konstantinos Safioleas, Athanasios Filios, Despoina Mytiliniou, Evangelos Rodinos, Panagiotis Filios, Dimitrios Dimitroulis\",\"doi\":\"10.1007/s11934-025-01282-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>Robotic assisted partial nephrectomy (RaPN) is the treatment of choice for small and resectable renal tumors offering better results in terms of blood loss, postoperative complications and length of hospital stay compared with the open partial nephrectomy (OPN), while for both techniques the risk of postoperative renal dysfunction is limited. However, the oncologic outcomes of the robotic procedure are yet to be determined. Therefore, a comprehensive research of PubMed/Medline, Embase and Scopus databases from the year 2000 till June 2024 was performed to elucidate the results related to oncologic outcomes. The ROBINS-I tool for non-randomized cohort studies was applied for the assessment of the quality of the included studies. All statistical analyses were performed with the use of STATA software version 15.0.</p><p><strong>Recent findings: </strong>The study was registered in International Platform of Registered Systematic Review and Metaanalysis Protocols database with the registration number INPLASY202450054. Overall 11 studies with 4758 patients were included in the present systematic review and meta-analysis. No statistically significant difference between the two treatment methods was reconded for the outcomes of overall survival [HR: 1.23 (95% CI: 0.68, 2.20)- p = 0.488], disease-specific survival [OR: 2.53 (95% CI: 0.65, 9.78)- p = 0.179], progression-free survival [HR: 1.04 (95% CI: 0.60, 1.79)- p = 0.901], recurrence-free survival [HR: 0.83 (95% CI = 0.54, 1.27)-p = 0.394] and disease-free survival [OR: 1.01 (95% CI = 0.98, 1.03)-p = 0.582]. The quality of most of the included studies was deemed moderate. 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引用次数: 0
摘要
综述目的：机器人辅助肾部分切除术（RaPN）是小且可切除的肾肿瘤的首选治疗方法，与开放式肾部分切除术（OPN）相比，在出血量、术后并发症和住院时间方面具有更好的效果，而这两种技术的术后肾功能障碍风险有限。然而，机器人手术的肿瘤学结果还有待确定。因此，我们对2000年至2024年6月的PubMed/Medline、Embase和Scopus数据库进行了综合研究，以阐明与肿瘤预后相关的结果。采用非随机队列研究的ROBINS-I工具评估纳入研究的质量。所有统计分析均使用STATA 15.0版软件进行。该研究已在国际注册系统评价和荟萃分析协议平台数据库中注册，注册号为INPLASY202450054。本系统综述和荟萃分析共纳入了11项研究，共4758例患者。两种治疗方法的总生存期[HR: 1.23 (95% CI: 0.68, 2.20)- p = 0.488]、疾病特异性生存期[OR: 2.53 (95% CI: 0.65, 9.78)- p = 0.179]、无进展生存期[HR: 1.04 (95% CI: 0.60, 1.79)- p = 0.901]、无复发生存期[HR: 0.83 (95% CI = 0.54, 1.27)-p = 0.394]和无疾病生存期[OR: 1.01 (95% CI = 0.98, 1.03)-p = 0.582]无统计学差异。大多数纳入研究的质量被认为是中等的。尽管需要更多高质量的比较研究，但假设这些结果可能有助于决策和咨询可切除肾肿瘤患者，他们可能会考虑保留肾元手术。
Comparison of Robot-Assisted Versus Open Partial Nephrectomy for Treating Renal Malignancies With An Emphasis on Oncological Outcomes: A Systematic Review and Meta-Analysis of The Literature.
Purpose of review: Robotic assisted partial nephrectomy (RaPN) is the treatment of choice for small and resectable renal tumors offering better results in terms of blood loss, postoperative complications and length of hospital stay compared with the open partial nephrectomy (OPN), while for both techniques the risk of postoperative renal dysfunction is limited. However, the oncologic outcomes of the robotic procedure are yet to be determined. Therefore, a comprehensive research of PubMed/Medline, Embase and Scopus databases from the year 2000 till June 2024 was performed to elucidate the results related to oncologic outcomes. The ROBINS-I tool for non-randomized cohort studies was applied for the assessment of the quality of the included studies. All statistical analyses were performed with the use of STATA software version 15.0.
Recent findings: The study was registered in International Platform of Registered Systematic Review and Metaanalysis Protocols database with the registration number INPLASY202450054. Overall 11 studies with 4758 patients were included in the present systematic review and meta-analysis. No statistically significant difference between the two treatment methods was reconded for the outcomes of overall survival [HR: 1.23 (95% CI: 0.68, 2.20)- p = 0.488], disease-specific survival [OR: 2.53 (95% CI: 0.65, 9.78)- p = 0.179], progression-free survival [HR: 1.04 (95% CI: 0.60, 1.79)- p = 0.901], recurrence-free survival [HR: 0.83 (95% CI = 0.54, 1.27)-p = 0.394] and disease-free survival [OR: 1.01 (95% CI = 0.98, 1.03)-p = 0.582]. The quality of most of the included studies was deemed moderate. Despite the need for more high quality comparative studies it is assumed that these results could be helpful in decision making and in counselling patients with resectable renal tumors to whom a nephron sparing surgery may be considered.
期刊介绍：
This journal intends to review the most important, recently published findings in the field of urology. By providing clear, insightful, balanced contributions by international experts, the journal elucidates current and emerging approaches to the care and prevention of urologic diseases and conditions.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as benign prostatic hyperplasia, erectile dysfunction, female urology, and kidney disease. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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