Robotic versus open radical cystectomy: an updated systematic review and meta-analysis
To critically review the currently available evidence of studies comparing robot-assisted radical cystectomy (RARC) with open radical cystectomy (ORC). A comprehensive review of the literature from Pubmed, Web of Science and Scopus was performed in April 2014. All relevant studies comparing RARC wit...
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| Veröffentlicht in: | PloS one 2015-03, Vol.10 (3), p.e0121032-e0121032 |
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| creator | Xia, Leilei Wang, Xianjin Xu, Tianyuan Zhang, Xiaohua Zhu, Zhaowei Qin, Liang Zhang, Xiang Fang, Chen Zhang, Minguang Zhong, Shan Shen, Zhoujun |
| description | To critically review the currently available evidence of studies comparing robot-assisted radical cystectomy (RARC) with open radical cystectomy (ORC).
A comprehensive review of the literature from Pubmed, Web of Science and Scopus was performed in April 2014. All relevant studies comparing RARC with ORC were included for further screening. A pooled meta-analysis of all comparative studies was performed and publication bias was assessed by a funnel plot.
Nineteen studies were included for the analysis, including a total of 1779 patients (787 patients in the RARC group and 992 patients in the ORC group). Although RARC was associated with longer operative time (p |
| doi_str_mv | 10.1371/journal.pone.0121032 |
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A comprehensive review of the literature from Pubmed, Web of Science and Scopus was performed in April 2014. All relevant studies comparing RARC with ORC were included for further screening. A pooled meta-analysis of all comparative studies was performed and publication bias was assessed by a funnel plot.
Nineteen studies were included for the analysis, including a total of 1779 patients (787 patients in the RARC group and 992 patients in the ORC group). Although RARC was associated with longer operative time (p <0.0001), patients in this group might benefit from significantly lower overall perioperative complication rates within 30 days and 90 days (p = 0.005 and 0.0002, respectively), more lymph node yields (p = 0.009), less estimated blood loss (p <0.00001), lower need for perioperative and intraoperative transfusions (p <0.0001 and <0.0001, respectively), and shorter postoperative length of stay (p = 0.0002). There was no difference between two groups regarding positive surgical margin rates (p = 0.19).
RARC appears to be an efficient alternative to ORC with advantages of less perioperative complications, more lymph node yields, less estimated blood loss, lower need for transfusions, and shorter postoperative length of stay. Further studies should be performed to compare the long-term oncologic outcomes between RARC and ORC.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0121032</identifier><identifier>PMID: 25825873</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Bladder cancer ; Blood ; Collaboration ; Comparative studies ; Complications ; Consortia ; Cost analysis ; Cystectomy - methods ; Female ; Hospitals ; Humans ; Laparoscopy ; Literature reviews ; Lymph nodes ; Lymphatic system ; Male ; Medicine ; Meta-analysis ; Middle Aged ; Minimally invasive surgery ; Mortality ; Patients ; Quality of life ; Robotic surgery ; Robotics ; Robots ; Studies ; Surgery ; Systematic review ; Upgrading ; Urology</subject><ispartof>PloS one, 2015-03, Vol.10 (3), p.e0121032-e0121032</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Xia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Xia et al 2015 Xia et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-fc17a4fe48447c7573fb4000f15ca3a288aaf529d2854df3dd633c25a090a093</citedby><cites>FETCH-LOGICAL-c692t-fc17a4fe48447c7573fb4000f15ca3a288aaf529d2854df3dd633c25a090a093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380496/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380496/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25825873$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Shore, Neal</contributor><creatorcontrib>Xia, Leilei</creatorcontrib><creatorcontrib>Wang, Xianjin</creatorcontrib><creatorcontrib>Xu, Tianyuan</creatorcontrib><creatorcontrib>Zhang, Xiaohua</creatorcontrib><creatorcontrib>Zhu, Zhaowei</creatorcontrib><creatorcontrib>Qin, Liang</creatorcontrib><creatorcontrib>Zhang, Xiang</creatorcontrib><creatorcontrib>Fang, Chen</creatorcontrib><creatorcontrib>Zhang, Minguang</creatorcontrib><creatorcontrib>Zhong, Shan</creatorcontrib><creatorcontrib>Shen, Zhoujun</creatorcontrib><title>Robotic versus open radical cystectomy: an updated systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>To critically review the currently available evidence of studies comparing robot-assisted radical cystectomy (RARC) with open radical cystectomy (ORC).
A comprehensive review of the literature from Pubmed, Web of Science and Scopus was performed in April 2014. All relevant studies comparing RARC with ORC were included for further screening. A pooled meta-analysis of all comparative studies was performed and publication bias was assessed by a funnel plot.
Nineteen studies were included for the analysis, including a total of 1779 patients (787 patients in the RARC group and 992 patients in the ORC group). Although RARC was associated with longer operative time (p <0.0001), patients in this group might benefit from significantly lower overall perioperative complication rates within 30 days and 90 days (p = 0.005 and 0.0002, respectively), more lymph node yields (p = 0.009), less estimated blood loss (p <0.00001), lower need for perioperative and intraoperative transfusions (p <0.0001 and <0.0001, respectively), and shorter postoperative length of stay (p = 0.0002). There was no difference between two groups regarding positive surgical margin rates (p = 0.19).
RARC appears to be an efficient alternative to ORC with advantages of less perioperative complications, more lymph node yields, less estimated blood loss, lower need for transfusions, and shorter postoperative length of stay. Further studies should be performed to compare the long-term oncologic outcomes between RARC and ORC.</description><subject>Analysis</subject><subject>Bladder cancer</subject><subject>Blood</subject><subject>Collaboration</subject><subject>Comparative studies</subject><subject>Complications</subject><subject>Consortia</subject><subject>Cost analysis</subject><subject>Cystectomy - methods</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Literature reviews</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medicine</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Minimally invasive surgery</subject><subject>Mortality</subject><subject>Patients</subject><subject>Quality of life</subject><subject>Robotic surgery</subject><subject>Robotics</subject><subject>Robots</subject><subject>Studies</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Upgrading</subject><subject>Urology</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNkttq3DAQhk1padJt36C0hkJpL3YrWZIPvSiE0MNCIJCG3IpZebSrYFtbSd52375y1gnrkoviI6PvH82M_iR5TcmCsoJ-urW966BZbG2HC0IzSlj2JDmlFcvmeUbY06P_k-SF97eECFbm-fPkJBNlvAt2mtxc2ZUNRqU7dL73qd1ilzqojYImVXsfUAXb7j-n0KX9toaAdeqHcAuDyuHO4O-4WKctBphDrGjvjX-ZPNPQeHw1fmfJ9bev1-c_5heX35fnZxdzlVdZmGtFC-Aaecl5oQpRML3ihBBNhQIGWVkCaJFVdVYKXmtW1zljKhNAKhIfNkveHtJuG-vlOBEvaZ4XlRCU5pFYHojawq3cOtOC20sLRt4FrFtLcLGTBiXXjHNYQQEi4zmWK4as5EhzrSC-acz1ZdytX7VYK-yCg2aSdLrSmY1c253krCS8Gor5MCZw9lePPsjWeIVNAx3a_q7uigsi4lHOknf_oI93N1JriA2YTtu4rxqSyjNOOWMFZwO1eISKV42tUdE-2sT4RPBxIohMwD9hDb33cvnz6v_Zy5sp-_6I3SA0YeNt0wdjOz8F-QFUznrvUD8MmRI5uP9-GnJwvxzdH2Vvjg_oQXRvd_YXw0D_Ug</recordid><startdate>20150331</startdate><enddate>20150331</enddate><creator>Xia, Leilei</creator><creator>Wang, Xianjin</creator><creator>Xu, Tianyuan</creator><creator>Zhang, Xiaohua</creator><creator>Zhu, Zhaowei</creator><creator>Qin, Liang</creator><creator>Zhang, Xiang</creator><creator>Fang, Chen</creator><creator>Zhang, Minguang</creator><creator>Zhong, Shan</creator><creator>Shen, Zhoujun</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20150331</creationdate><title>Robotic versus open radical cystectomy: an updated systematic review and meta-analysis</title><author>Xia, Leilei ; Wang, Xianjin ; Xu, Tianyuan ; Zhang, Xiaohua ; Zhu, Zhaowei ; Qin, Liang ; Zhang, Xiang ; Fang, Chen ; Zhang, Minguang ; Zhong, Shan ; Shen, Zhoujun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-fc17a4fe48447c7573fb4000f15ca3a288aaf529d2854df3dd633c25a090a093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Analysis</topic><topic>Bladder cancer</topic><topic>Blood</topic><topic>Collaboration</topic><topic>Comparative studies</topic><topic>Complications</topic><topic>Consortia</topic><topic>Cost analysis</topic><topic>Cystectomy - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xia, Leilei</au><au>Wang, Xianjin</au><au>Xu, Tianyuan</au><au>Zhang, Xiaohua</au><au>Zhu, Zhaowei</au><au>Qin, Liang</au><au>Zhang, Xiang</au><au>Fang, Chen</au><au>Zhang, Minguang</au><au>Zhong, Shan</au><au>Shen, Zhoujun</au><au>Shore, Neal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic versus open radical cystectomy: an updated systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-03-31</date><risdate>2015</risdate><volume>10</volume><issue>3</issue><spage>e0121032</spage><epage>e0121032</epage><pages>e0121032-e0121032</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To critically review the currently available evidence of studies comparing robot-assisted radical cystectomy (RARC) with open radical cystectomy (ORC).
A comprehensive review of the literature from Pubmed, Web of Science and Scopus was performed in April 2014. All relevant studies comparing RARC with ORC were included for further screening. A pooled meta-analysis of all comparative studies was performed and publication bias was assessed by a funnel plot.
Nineteen studies were included for the analysis, including a total of 1779 patients (787 patients in the RARC group and 992 patients in the ORC group). Although RARC was associated with longer operative time (p <0.0001), patients in this group might benefit from significantly lower overall perioperative complication rates within 30 days and 90 days (p = 0.005 and 0.0002, respectively), more lymph node yields (p = 0.009), less estimated blood loss (p <0.00001), lower need for perioperative and intraoperative transfusions (p <0.0001 and <0.0001, respectively), and shorter postoperative length of stay (p = 0.0002). There was no difference between two groups regarding positive surgical margin rates (p = 0.19).
RARC appears to be an efficient alternative to ORC with advantages of less perioperative complications, more lymph node yields, less estimated blood loss, lower need for transfusions, and shorter postoperative length of stay. Further studies should be performed to compare the long-term oncologic outcomes between RARC and ORC.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>25825873</pmid><doi>10.1371/journal.pone.0121032</doi><oa>free_for_read</oa></addata></record> |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Bladder cancer Blood Collaboration Comparative studies Complications Consortia Cost analysis Cystectomy - methods Female Hospitals Humans Laparoscopy Literature reviews Lymph nodes Lymphatic system Male Medicine Meta-analysis Middle Aged Minimally invasive surgery Mortality Patients Quality of life Robotic surgery Robotics Robots Studies Surgery Systematic review Upgrading Urology |
| title | Robotic versus open radical cystectomy: an updated systematic review and meta-analysis |
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