Systematic review and meta-analysis of randomised trials of perioperative outcomes comparing robot-assisted versus open radical cystectomy

BACKGROUND With the introduction of robotic surgery, whether the robot-assisted radical cystectomy (RARC) could reduce the perioperative morbidity compared with Open radical cystectomy (ORC) was unknown. METHODS Studies reported RARC were reviewed based on all randomized controlled trials (RCTs), which focused on the efficacy of RARC versus ORC. RESULTS Of the 201 studies from preliminary screening, four RCTs were included. By pooling these studies, there were significant differences in comparison of operative time (p = 0.007), estimated blood loss (EBL) (p < 0.001) and time to diet (p < 0.001) between the RARC group and ORC groups. There was no significant difference regarding perioperative complications (Clavien 2-5, Clavien 3-5), length of stay (LOS), positive surgical margins (PSM) and lymph node positive. CONCLUSION This meta-analysis presented evidence for a benefit of EBL, time to diet, similar perioperative complications and oncological outcomes, but a longer operative time in RARC. It is noted that RARC was considered as a comparable surgical procedure to ORC.