Robot-assisted And Laparoscopic Repair Of Ureteropelvic Junction Obstruction: A Meta-analysis

Objective:To critically analyse outcomes for robot-assisted laparoscopic pyeloplasty vs laparoscopic pyeloplasty by meta-analysis of published data.Methods:A systematic literature review was performed from January 2002 to December 2014 from multiple literature databases in domestic and foreign. Only comparative studies investigating RALP vs LP were included.Article selection proceeded according to the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria.Using Rev-Man 5.3 software for the processing of the data.Results:Finally,10 observational studies met inclusion criteria,reporting outcomes of 497 patients. controlled clinical studies were concluded,including 259 cases of RALP and 238 cases of LP. Meta-analysis showed that RALP was associated with a 13.06 min reduction in suturing time(WMD=﹣13.06,95%CI ﹣22.54~﹣3.58,P=0.007)and a 1.4 day decrease in mean length of hospital stay(WMD=﹣ 1.40,95%CI﹣2.04 ~﹣0.76,P<0.0001)compared with LP.The complication rate of RALP was superior to the LP(OR=0.53,95%CI 0.29~0.98,P=0.04).There were no obvious differences between the approaches in operative time(WMD=﹣1.40,95%CI﹣2.04~﹣0.76,P<0.0001),success rate(OR=1.17,95%CI 0.53~2.57,P>0.05)and blood loss(WMD=4.07,95%CI﹣6.44~14.58,P>0.05).Conclusions:RALP is safe and effective in the treatment of ureteropelvic junction obstruction,which is worth to be popularized in clinic.