Robot-Assisted versus Conventional Open Kidney Transplantation: A Meta-Analysis

Autor: Tingshen Lin, Guangxiang Liu, Yongming Deng, Hongqian Guo, Shenjie Zhang
Rok vydání: 2020
Předmět:
Graft Rejection
Risk
medicine.medical_specialty
Operative Time
030232 urology & nephrology
Delayed Graft Function
Review Article
030230 surgery
Cochrane Library
Lower risk
Nephrectomy
General Biochemistry
Genetics and Molecular Biology
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Robotic Surgical Procedures
Internal medicine
Living Donors
medicine
Humans
Surgical Wound Infection
Postoperative Period
Perioperative Period
Kidney transplantation
Clinical Trials as Topic
Creatinine
General Immunology and Microbiology
business.industry
Incidence (epidemiology)
Graft Survival
Reproducibility of Results
General Medicine
Perioperative
Length of Stay
Creatine
medicine.disease
Kidney Transplantation
Hospitalization
chemistry
Meta-analysis
Relative risk
Medicine
Kidney Failure
Chronic
Patient Safety
business
Follow-Up Studies
Zdroj: BioMed Research International
BioMed Research International, Vol 2020 (2020)
ISSN: 2314-6141
2314-6133
Popis: Background. Perioperative and follow-up outcomes for patients that received robot-assisted kidney transplant (RAKT), compared to patients that received conventional open kidney transplant (OKT), remain unknown. We performed a meta-analysis of controlled studies to compare the safety and efficacy of RAKT versus OKT. Methods. Systematic searching of PubMed, Embase, and Cochrane Library databases was performed to identify relevant randomized or nonrandomized controlled studies. Perioperative, in-hospital, and follow-up outcomes were summarized. A random-effect model incorporating the potential heterogeneity was used to synthesize the results. Results. Six nonrandomized controlled studies including 263 patients with RAKT and 804 patients with OKT were included. Pooled results showed that compared to those that received OKT, patients that received RAKT had significant higher rewarming time (mean difference (MD): 20.8 min, p < 0.001 ) and total ischemia time (MD: 17.8 min, p = 0.008 ) but a lower incidence of surgical site infection (SSI, risk ratio (RR): 0.22, p = 0.03 ). The incidence of delayed graft function was comparable between groups (RR: 1.10, p = 0.82 ), and the length of hospital stay was similar (MD: -2.03 days, p = 0.21 ). During a follow-up of 31 months, patients that received RAKT and OKT had similar serum creatinine levels (MD: 10.12 mmol/L, p = 0.42 ) and similar incidences of graft rejection (RR: 1.16, p = 0.53 ), graft failure (RR: 0.94, p = 0.79 ), and all-cause mortality (RR: 1.16, p = 0.77 ). Conclusion. Current evidence from nonrandomized studies suggests that RAKT is associated with a lower risk of SSI and similar midterm functional and clinical efficacy compared to OKT. Randomized studies are needed to validate these findings.
Databáze: OpenAIRE
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