Intra-corporeal robot-assisted versus open radical cystectomy: a meta-analysis

作者：Gan L, Wu J, Li Z, Cao H, Wang H, Li Y, Sun Z, Wang W · 发表于：World journal of urology · 年份：2026 · DOI：10.1007/s00345-026-06641-5 · 研究领域：Cystectomy、Robotic Surgical Procedures、Urinary Bladder Neoplasms、Urinary Diversion、Humans、Postoperative Complications

OBJECTIVE: To compare the safety and effectiveness between robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) and open radical cystectomy (ORC). METHODS: We conducted this systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA and AMSTAR Guidelines. Five databases were systematically searched, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science. The search timeframe was set from database creation to February 2026. RESULTS: There were 30 studies including 8857 patients. Compared with ORC, iRARC was superior in terms of estimated blood loss [WMD=-523.18, 95% CI (-622.68, -423.68), P < 0.01], length of stay [WMD=-2.30, 95% CI (-3.27, -1.33), P < 0.01], lymph nodes removed [WMD = 2.39, 95% CI (0.16, 4.62), P < 0.05], transfusion [OR = 0.15, 95% CI (0.08, 0.29), P < 0.01], positive surgical margin [OR = 0.73, 95% CI (0.55, 0.96), P < 0.05], postoperative complications [OR = 0.59, 95% CI (0.37, 0.95), P < 0.05], Clavien-Dindo > II complications [OR = 0.66, 95% CI (0.47, 0.94), P < 0.05], and intraoperative complications [OR = 0.51, 95% CI (0.26, 0.97), P < 0.05], but it had a longer operative time [WMD = 66.11, 95% CI (45.31, 86.90), P < 0.01]. The two surgical groups were comparable in terms of solid food intake time (p = 0.29), bowel obstruction (p = 0.36), and Clavien-Dindo I-II complications (p = 0.34). Postoperative long-term follow-up results showed that iRARC was superior in terms of ...