Comparative short-term efficacy and safety analysis of a single-port robot in nephrectomy
摘要
The objective of the study is to conduct a systematic assessment of the clinical effectiveness differences between single-port and multi-port robotic surgical systems in the context of renal tumor removal, grounded in evidence-based medical data. Adhering to PRISMA standards, a comprehensive literature search was executed across PubMed, Embase, Cochrane Library, and Web of Science from their inception until March 2025. The search included randomized controlled trials and cohort studies that compared single-port and multi-port robotic systems for partial or radical nephrectomy. Statistical analysis of the outcomes was carried out using Stata 15.0, with the results presented as weighted mean difference (WMD) and odds ratio (OR). Subgroup analyses were conducted to examine the consistency of the findings with respect to thermal ischemia duration. A combined analysis of 11 studies, comprising 1729 participants, were analyzed, with 654 individuals in the single-port cohort and 1075 in the multi-port cohort. The meta-analysis revealed a significantly shorter hospital stay for the single-port cohort compared to the multi-port cohort (WMD = −0.32, 95% CI −0.47, −0.17, p < 0.05). However, the single-port cohort also experienced a longer thermal ischemia time (WMD = 2.92, 95% CI 0.45, 5.38, p < 0.05). No statistically significant differences were found between the two cohorts regarding complication rates, intraoperative blood loss, operative time, positive margin rates, conversion rates, or tumor recurrence rates. Single-port robotic nephrectomy for renal tumors can enhance postoperative recovery without compromising oncologic safety. Nevertheless, its effect on renal function preservation requires careful evaluation. Future investigations ought to encompass extended, high-caliber studies to offer more substantial data for clinical choices.