Clinical Effect Meta-analysis On Robotics-assisted And Laparoscopic Partial Nephrectomy

Background Da Vinci robotic system in urology surgery has been widely used, despite the obvious advantages of it, but for now, it remains controversial in term of the efficacy and safety for the laparoscopic partial nephrectomy and robotic partial nephrectomy. Objective:Application of Meta-analysis to evaluate roboticpartialnephrectomy and laparoscopic partial nephrectomy of clinical effect. Methods Searching Pubmed,CNKI,and cpvip,with the data ranging from January1966to May2013. The related literature protocol using the terms such as Robotics AND Nephrectomy,Robotics AND Nephrectomy AND Laparoscopy,Robotics AND Laparoscopy AND Nephrectomy AND Partial,LPN AND RPN was applied. A cumulative analysis was conducted using Review Manager software5.2.5(Java6). The following variables were compared estimated blood loss, operating time, warm ischaemic time, positive margin, complications and length of hospital stay. Results We isolated10relevant studies, all of which were dominated by foreign language, Specific statistic numerical in this Meta-analysis is as follow:estimated blood loss [I2=77%, MD=-10.01,95%CI (62.74,42.72), Z=0.37,P=0.71]; operating time[I2=92%, MD=-4.54,95%CI(-29.04,19.96), Z=0.36, P=0.72]; warm ischaemic time[MD=-1.47,95%CI(-2.82,-0.11), Z=2.12, P=0.03]; complications[OR=1.35,95%CI(0.67,2.74), Z=0.84P=0.40]; positive margin[OR=1.91,95%CI(0.50,7.29), Z=0.95, P=0.34]; length of hospital stay[MD=-0.08,95%CI(-0.37,0.22), Z=0.50, P=0.62]。The warm ischemia time difference between the two groups have statistical significance, suggesting RPN is better than that of the LPN group in warm ischemia time. RPN less damage to the kidney, can better protect renal function.And each other is no statistical significance. Conclusion RPN and LPH have exerted the same effect on the operation, and have less warm ischemia time than LPN, Which plays a positive role in the protection of the renal function.