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Intra-corporeal robot-assisted versus open radical cystectomy: a meta-analysis.

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Τίτλος: Intra-corporeal robot-assisted versus open radical cystectomy: a meta-analysis.
Συγγραφείς: Gan L; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China., Wu J; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China., Li Z; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China., Cao H; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China., Wang H; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China., Li Y; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China., Sun Z; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China. mnwkszj5076@163.com., Wang W; Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gong Ti Nan Road, Chaoyang District, Beijing, 100020, China. weiwang0920@163.com.
Πηγή: World journal of urology [World J Urol] 2026 Jul 29; Vol. 44 (1). Date of Electronic Publication: 2026 Jul 29.
Τύπος έκδοσης: Journal Article; Meta-Analysis; Systematic Review; Comparative Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer International Country of Publication: Germany NLM ID: 8307716 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-8726 (Electronic) Linking ISSN: 07244983 NLM ISO Abbreviation: World J Urol Subsets: MEDLINE
Imprint Name(s): Original Publication: [Berlin ; New York] : Springer International, 1983-
Ιατρικοί όροι (MeSH): Cystectomy*/methods , Robotic Surgical Procedures*/methods , Urinary Bladder Neoplasms*/surgery , Urinary Diversion*/methods, Postoperative Complications/epidemiology ; Humans
Περίληψη: Objective: To compare the safety and effectiveness between robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) and open radical cystectomy (ORC).
Methods: We conducted this systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA and AMSTAR Guidelines. Five databases were systematically searched, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science. The search timeframe was set from database creation to February 2026.
Results: There were 30 studies including 8857 patients. Compared with ORC, iRARC was superior in terms of estimated blood loss [WMD=-523.18, 95% CI (-622.68, -423.68), P < 0.01], length of stay [WMD=-2.30, 95% CI (-3.27, -1.33), P < 0.01], lymph nodes removed [WMD = 2.39, 95% CI (0.16, 4.62), P < 0.05], transfusion [OR = 0.15, 95% CI (0.08, 0.29), P < 0.01], positive surgical margin [OR = 0.73, 95% CI (0.55, 0.96), P < 0.05], postoperative complications [OR = 0.59, 95% CI (0.37, 0.95), P < 0.05], Clavien-Dindo > II complications [OR = 0.66, 95% CI (0.47, 0.94), P < 0.05], and intraoperative complications [OR = 0.51, 95% CI (0.26, 0.97), P < 0.05], but it had a longer operative time [WMD = 66.11, 95% CI (45.31, 86.90), P < 0.01]. The two surgical groups were comparable in terms of solid food intake time (p = 0.29), bowel obstruction (p = 0.36), and Clavien-Dindo I-II complications (p = 0.34). Postoperative long-term follow-up results showed that iRARC was superior in terms of 30-day complications [OR = 0.58, 95% CI (0.38, 0.88), P < 0.05], 90-day complications [OR = 0.67, 95% CI (0.58, 0.78), P < 0.01], 30-day Clavien-Dindo > II complications [OR = 0.66, 95% CI (0.52, 0.84), P < 0.05], 90-day Clavien-Dindo > II complications [OR = 0.77, 95% CI (0.63, 0.94), P < 0.01], 5-year cancer-specific survival [CSS HR = 0.71, 95% CI (0.51, 0.98), P < 0.05], and 5-year overall survival [OS HR = 0.73, 95% CI (0.60, 0.87), P < 0.01], but it had a higher incidence of ureteroenteric stricture [UES OR = 1.57, 95% CI (1.18, 2.09), P < 0.01]. The two surgical groups were comparable in terms of 30-day Clavien-Dindo I-II complications (p = 0.28), 90-day Clavien-Dindo I-II complications (p = 0.99), 30-day readmission (p = 0.68), 90-day readmission (p = 0.51), 90-day death (p = 0.37), recurrence (p = 0.18), 3-year CSS (p = 0.88), and 3-year OS (p = 0.19).
Conclusion: Compared with ORC, iRARC was associated with improved perioperative outcomes, but attention should be paid to the monitoring and management of postoperative UES. Although improved 5-year OS and CSS were observed, these findings should be interpreted with caution because most of the available evidence was derived from observational studies and may have been influenced by residual confounding. Further large-scale, high-quality randomized controlled trials are needed to validate these findings.
(© 2026. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Ethics and consent to participate declarations: Not applicable.
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Grant Information: Z221100007422029 Beijing Municipal Science and Technology Commission; CYFH202203 Clinical Research Incubation Project of Beijing Chao-yang Hospital, Capital Medical University
Contributed Indexing: Keywords: Bladder cancer; Open radical cystectomy; Robot-assisted radical cystectomy
Entry Date(s): Date Created: 20260729 Date Completed: 20260729 Latest Revision: 20260729
Update Code: 20260730
DOI: 10.1007/s00345-026-06641-5
PMID: 42525253
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1433-8726
DOI:10.1007/s00345-026-06641-5