Comparison The Efficacy Between Robotic-assisted And Laparoscopic Radical Cystectomy:A Meta-Analysis

Objective:The Meta-analysis is used to compare the differences in perioperative efficacy and oncology results between robot-assisted radical cystectomy(RARC)and laparoscopic radical cystectomy(LRC),aiming to provide evidence-based medicine evidence for clinical practice.Methods:We search all published literature on the comparison of the efficacy between robot-assisted radical cystectomy and laparoscopic radical cystectomy in Pub Med,Med Line,Web of Science,Embase,Cochrane,CNKI,Wanfang Medical Network and VIP database.The language is limited to Chinese and English,and the time is from the creation of the database to May 31,2020.On this basis,the literature was screened according to the established standards,and the required literature data was collected and sorted,then we use the Rev Man 5.3 and Stata 15.0software to Meta-analysis.Results:This meta-analysis finally include thirteen articles,including four Chinese and nine English literatures.A total of 1244 patients were included,including 690 patients in RARC group and 554 patients in LRC group.The results of meta-analysis showed that:(1)there was no significant difference in one-year recurrence rate(P=0.86),three-year recurrence rate(P=0.58),one-year survival rate(P=0.41),three-year survival rate(P=0.38),operation time(P=0.55),postoperative eating time(P=0.43),lymph node positive detection rate(P=0.28)and positive surgical margin(P=0.33)in RARC group compared with LRC group.(2)There were statistically significant less intraoperative blood loss(P=0.002),lower intraoperative transfusion rate(P=0.005),shorter postoperative hospital stay(P=0.004),more lymph node yield(P=0.0007),and fewer overall,minor and major postoperative complications(P=0.0008,P=0.007,P<0.0001)in RARC group compared with LRC group.Conclusion:This meta-analysis was conducted to compare the related parameters after laparoscopic and robotic radical cystectomy.The results showed that compared with traditional laparoscopic cystectomy,robotic surgery can reduce the amount of intraoperative bleeding,shorten postoperative hospital stay,and reduce postoperative complications.It is no significant difference in oncologic outcomes between the RARC and LRC.