Meta-analysis: Comparison Of Clinical Efficacy In Robot-assisted Versus Laparoscopic Radical Cystectomy

Objective:Meta-analysis was performed to compare the preoperative,perioperative,complications,and prognosis of patients undergoing Robot-assisted Laparoscopic Radical cystectomy(RARC)and laparoscopic Radical cystectomy(LRC).METHODS: The researches on robot-assisted laparoscopic Radical cystectomy(RARC)and pure laparoscopic Radical cystectomy(LRC)were searched in a number of databases at home and abroad,including Pub Med,The Cochrane Library,Embase,Wanfang,CNKI,etc,From the construction of the database to 2021 January.NOS and Jaddad scale were used for quality evaluation.The outcome indicator were Preoperative status,Perioperative indicators,Incidence of complication and prognosis of tumor,OR value and 95% confidence interval were used for Dichotomous variables,MD value and95% confidence interval were used for continuous variables,and Egger’s graph was used for publication bias.RESULTS: 17 literatures were included in the study,and there were no statistically significant differences between RARC and LRC patients in age,male proportion,BMI,preoperative ASA classification,previous abdominal surgery history,and preoperative clinical staging.More patients in the RARC group received neoadjuvant chemotherapy preoperatively.Among the perioperative indicators,there was a statistically significant difference in the amount of intraoperative blood loss between the RARC group and the LRC group,and the amount of blood loss in the RARC group was less.In terms of postoperative complications,there was no statistically significant difference in the incidence of total complications between the RARC group and the LRC group,but there was a significant difference in the incidence of major complications,with fewer major complications in the RARC group.In terms of postoperative pathology,there was a statistically significant difference in the number of dissected lymph nodes between the RARC group and the LRC group,and the number of dissected lymph nodes in the RARC group was more.Conclusions: Our data suggest that,partly,RARC is a better option than LRC in terms of estimated blood loss,major complications and mean lymph node yield.However,at present,RARC still has no obvious advantages over LRC in most other clinical efficacy comparisons.LRC is still an important surgical method for most medical institutions.