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SYSTEMATIC REVIEW article

Front. Oncol.
Sec. Genitourinary Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1444477
This article is part of the Research Topic The Evolution of Minimally Invasive Urologic Surgery: Innovations, Challenges, and Opportunities View all 16 articles

Impacts of Completely Endophytic Renal Masses on Perioperative, Oncologic, and Functional Outcomes in Robot-Assisted Partial Nephrectomy: A Systematic Review and Meta-Analysis

Provisionally accepted
Han-xiao Gu Han-xiao Gu 1Jia Lv Jia Lv 1Yi Liu Yi Liu 2Hai-long Wang Hai-long Wang 1*
  • 1 Baoji Traditional Chinese Medicine Hospital, Baoji, China
  • 2 Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu Province, China

The final, formatted version of the article will be published soon.

    The objective of this study was to perform a comprehensive pooled analysis aimed at comparing the efficacy and safety of robot-assisted partial nephrectomy (RAPN) between completely endophytic tumors (CERT) and noncompletely endophytic tumors (non-CERT).Methods: This study adhered rigorously to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to conduct a systematic review and meta-analysis. We performed a systematic search in the PubMed, Embase, Web of Science, and Cochrane Library databases, focusing on studies published in English up to May 2024. Our analysis primarily evaluated key outcomes, specifically perioperative, functional, and oncological outcomes.Results: A total of 2126 patients across six studies were included in the analysis.Compared to non-CERT, CERT was associated with significantly higher rates of major complications (Odds Ratio [OR]: 2.47; 95% CI: 1.14 to 5.34; p = 0.02), longer warm ischemia times (Weighted Mean Difference [WMD]: 3.27 min; 95% CI: 0.61 to 5.39; p = 0.02), a greater decline in estimated glomerular filtration rate (eGFR) (WMD: 2.93 ml/min/1.73 m 2 ; 95% CI: 0.75 to 5.11; p = 0.008), and relatively lower trifecta achievement rates (OR: 0.63; 95% CI: 0.41 to 0.96; p = 0.03). However, no statistically significant differences were observed between the two groups in terms of operative time, length of stay, blood loss, transfusion rates, intraoperative complications, overall complications, positive surgical margins, and local recurrence.Although CERT was associated with greater declines in eGFR and lower rates of trifecta achievement, it yielded perioperative, functional, and oncologic outcomes comparable to those of non-CERT in RAPN. Our findings suggest that RAPN for completely endophytic renal masses can achieve acceptable outcomes when performed in centers with substantial expertise in robotic surgery.

    Keywords: Completely endophytic tumors, Non-completely endophytic tumors, Robot-Assisted Partial Nephrectomy, outcomes, Meta-analysis

    Received: 05 Jun 2024; Accepted: 07 Oct 2024.

    Copyright: © 2024 Gu, Lv, Liu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hai-long Wang, Baoji Traditional Chinese Medicine Hospital, Baoji, China

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