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<p>Radical nephrectomy is indicated for renal neoplasms when nephron-sparing surgery is not feasible. While traditional laparoscopic radical nephrectomy (LRN) improves outcomes, it is limited by technical constraints. Robot-assisted radical nephrectomy (RRN) offers enhanced dexterity and visualisation, but comparative evidence remains inconclusive. This systematic review and meta-analysis (SRMA) compares outcomes of RRN and LRN.This SRMA followed PRISMA 2020 guidelines and was registered in PROSPERO. Databases including PubMed, Embase, Scopus, Cochrane Central, and ClinicalTrials.gov were searched up to November 2025. Cohort studies comparing RRN and LRN in adults were included. Risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analysis, sensitivity and regression analyses were conducted using R version 4.5.2, reporting odds ratios or mean differences with 95% confidence intervals; <i>p</i> &lt; 0.05 was considered significant. Thirteen studies comprising 86,975 patients (RRN: 29,983; LRN: 56,992) were included. RRN was associated with significantly longer operative times (MD 30.80&#xa0;min; 95% CI 13.14 to 48.46; <i>p</i> = 0.0006) but demonstrated lower mortality (OR 0.59; 95% CI 0.40 to 0.87; <i>p</i> = 0.008) and readmission rates (OR 0.43; 95% CI 0.24 to 0.75; <i>p</i> = 0.019). Conversely, recurrence was significantly higher in the RRN group (OR 1.96; 95% CI 1.23 to 3.12; <i>p</i> = 0.024). No significant differences were observed regarding estimated blood loss, transfusions, complications, infections, length of hospital stay, or conversion to open surgery. High heterogeneity (I<sup>2</sup> &gt; 50%) was observed for length of stay, operative time, estimated blood loss, conversion to open surgery, overall complications, and infection. The intraoperative outcomes remained largely comparable between the two groups. However, RRN demonstrated longer operative times but offered reduced mortality, recurrence, and readmission. The utility of robotic assistance may be optimised in centres with the appropriate expertise and suitable patient profiles. The non-significant perioperative outcomes warrant further robust investigation.</p>

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Robot-Assisted Versus Standard Laparoscopic Radical Nephrectomy for Renal Tumors: An Updated Systematic Review And Meta-Analysis with Meta-Regression

  • 期刊论文

  • 发表日期：

    2026年2月25日

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  • Fahad Amin,
  • Ammad Abid,
  • Tahzeeb Afzal,
  • Abdul Sami Ur Rehman Ghani,
  • Taimoor Hassan,
  • Abdul Rehman Azam,
  • Salma Mohamed Awadallah,
  • Maiza Naseer,
  • Khadija Mohib,
  • Arbab Khalid

摘要

Radical nephrectomy is indicated for renal neoplasms when nephron-sparing surgery is not feasible. While traditional laparoscopic radical nephrectomy (LRN) improves outcomes, it is limited by technical constraints. Robot-assisted radical nephrectomy (RRN) offers enhanced dexterity and visualisation, but comparative evidence remains inconclusive. This systematic review and meta-analysis (SRMA) compares outcomes of RRN and LRN.This SRMA followed PRISMA 2020 guidelines and was registered in PROSPERO. Databases including PubMed, Embase, Scopus, Cochrane Central, and ClinicalTrials.gov were searched up to November 2025. Cohort studies comparing RRN and LRN in adults were included. Risk of bias was assessed using the Newcastle–Ottawa Scale. Meta-analysis, sensitivity and regression analyses were conducted using R version 4.5.2, reporting odds ratios or mean differences with 95% confidence intervals; p < 0.05 was considered significant. Thirteen studies comprising 86,975 patients (RRN: 29,983; LRN: 56,992) were included. RRN was associated with significantly longer operative times (MD 30.80 min; 95% CI 13.14 to 48.46; p = 0.0006) but demonstrated lower mortality (OR 0.59; 95% CI 0.40 to 0.87; p = 0.008) and readmission rates (OR 0.43; 95% CI 0.24 to 0.75; p = 0.019). Conversely, recurrence was significantly higher in the RRN group (OR 1.96; 95% CI 1.23 to 3.12; p = 0.024). No significant differences were observed regarding estimated blood loss, transfusions, complications, infections, length of hospital stay, or conversion to open surgery. High heterogeneity (I2 > 50%) was observed for length of stay, operative time, estimated blood loss, conversion to open surgery, overall complications, and infection. The intraoperative outcomes remained largely comparable between the two groups. However, RRN demonstrated longer operative times but offered reduced mortality, recurrence, and readmission. The utility of robotic assistance may be optimised in centres with the appropriate expertise and suitable patient profiles. The non-significant perioperative outcomes warrant further robust investigation.