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Abstract：
Renal cell carcinoma (RCC) is an adenocarcinoma of the renal cortex. Radical nephrectomy remains the standard of care for managing massive renal tumours. Robotic-assisted radical nephrectomy is an increasing alternative technique to laparoscopic radical nephrectomy (LRN). The da Vinci Surgical System allows for improved dexterity, increased visualisation, tremor filtration and an ergonomic setting to enhance surgeon comfort. The aim was to compare the perioperative outcomes pertaining to operative time, intraoperative complications, blood loss and length of hospital stay between the robotic and LRN for RCC. Studies that compared the perioperative findings between robotic radical nephrectomy (RNN) and LRN for RCC were included. The literature review was carried out according to the Cochrane collaboration standards where applicable. Highly sensitive search strategies like MeSH terms and controlled vocabularies were used to identify relevant studies that compare the RNN outcomes to the LRN. Following the literature search, a total of 73 articles were collected, 60 articles were excluded at the stage of reviewing the titles, eight articles were excluded after reading the abstracts, and five articles were included in this paper. Five studies were included in this analysis, with a total sample size of 1770 patients, 735 were in the robotic arm, and 1035 were in the laparoscopic arm. Generally, there were no differences between both arms in terms of demographic data and age of patients. Closer analysis of the perioperative outcomes did not reveal significant differences between the two groups related to the estimated blood loss, length of hospital stay or post-operative complications. The laparoscopic techniques have less operative time than the robotic ones. RRN is an expanding approach for patients with RCC with some potential technical benefits over laparoscopic ones. RRN is similar to LRN in the perioperative outcomes, with few potential drawbacks of RRN, including higher costs. However, a prospective comparison of RRN with LRN in many cases at multiple centres with long-term oncological results best illustrates the status of RRN versus LRN.
摘要：
肾细胞癌（RCC）是肾皮质的腺癌。根治性肾切除术仍然是治疗大量肾肿瘤的标准护理。机器人辅助的根治性肾切除术是腹腔镜根治性肾切除术（LRN）的一种替代技术。达芬奇手术系统可以提高灵活性，增加了可视化，震颤过滤和符合人体工程学的设置，以提高外科医生的舒适度。目的是比较与手术时间有关的围手术期结局，术中并发症,RCC机器人和LRN之间的失血量和住院时间。包括比较机器人根治性肾切除术（RNN）和LRN治疗RCC的围手术期结果的研究。文献综述是根据适用的Cochrane协作标准进行的。使用MeSH术语和受控词汇等高度敏感的搜索策略来识别将RNN结果与LRN进行比较的相关研究。在文献检索之后,共收集了73篇文章，在审题阶段排除了60篇文章,阅读摘要后排除了八篇文章，本文包括五篇文章。这项分析包括五项研究，总样本量为1770名患者，735人在机械臂中，和1035在腹腔镜臂。一般来说,两组之间在人口统计学数据和患者年龄方面没有差异.对围手术期结局的更仔细分析未发现两组之间在估计的失血量方面存在显著差异。住院时间或术后并发症。腹腔镜技术比机器人技术具有更少的手术时间。RRN是RCC患者的一种扩展方法，与腹腔镜相比具有一些潜在的技术优势。RRN与LRN的围手术期结局相似，RRN几乎没有潜在的缺点，包括更高的成本。然而,在具有长期肿瘤学结果的多个中心的许多病例中，RRN与LRN的前瞻性比较最能说明RRN与LRN的状态。
