687 Comparison of Perioperative Outcomes Betweenlaparoscopic Versus Open Versus Robotic Partialnephrectomy: A Systematic Review
R Wong, S Biyani- Surgery
Abstract
Aim
This systematic review aims to evaluate the perioperative outcomes between laparoscopic (LPN), open (OPN), and robotic-assisted partial nephrectomy (RPN) using the standardised system, Clavien-Dindo Classification (CDC).
Method
The systematic review was conducted in accordance with the PRISMA guidelines. A search was performed on Cochrane, Embase and PubMed databases. Articles between January 2016 to December 2021 were included. Perioperative outcomes investigated include: estimated blood loss (EBL), operating time (OT), conversion rate (CR), warm ischaemia time (WIT), positive surgical margin (PSM), and postoperative complications using CDC.
Results
This study included 12 studies, with a total of 3,908 patients. (LPN = 1,120, OPN = 1,206, RPN = 1,580). LPN demonstrated a lower overall EBL (p = 0.004). There was no significant difference between OT (p = 0.291), CR (p = 0.200), WIT (p = 0.760), PSM (p = 0.549), CDC I (p = 0.556), CDC II (p = 0.779) and CDC≥III (p = 0.663) of the three surgical approaches.
Conclusions
Compared with OPN and RPN, LPN demonstrated a lower EBL. All other perioperative outcomes demonstrated similar results between the three treatment modalities. Future large-scale, prospective, randomised studies is necessary to draw a definitive conclusion from this analysis.