PD31-02 ROBOTIC ASSISTED KIDNEY TRANSPLANT STILL FAILING TO IMPRESS: A SYSTEMATIC REVIEW AND META-ANALYSIS

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You have accessJournal of UrologyCME1 Apr 2023PD31-02 ROBOTIC ASSISTED KIDNEY TRANSPLANT STILL FAILING TO IMPRESS: A SYSTEMATIC REVIEW AND META-ANALYSIS Tuan Thanh Nguyen, Adnan El-Achkar, Berut Lebanon, Ho Yee Tiong, Ryan W. Dobbs, Huy Gia Vuong, Jacob Basilius, Le Quy Van Dinh, Ho Chi Minh, Vietnam, Jad Najdi, Trong Hieu Le, Tien-Dat Hoang, Khoa Quy, Ali Sohrab Naushad, Mohammed Shahait, Amman Jordan, and David I. Lee Tuan Thanh NguyenTuan Thanh Nguyen More articles by this author , Adnan El-AchkarAdnan El-Achkar More articles by this author , Berut LebanonBerut Lebanon More articles by this author , Ho Yee TiongHo Yee Tiong More articles by this author , Ryan W. DobbsRyan W. Dobbs More articles by this author , Huy Gia VuongHuy Gia Vuong More articles by this author , Jacob BasiliusJacob Basilius More articles by this author , Le Quy Van DinhLe Quy Van Dinh More articles by this author , Ho Chi MinhHo Chi Minh More articles by this author , Vietnam Vietnam More articles by this author , Jad NajdiJad Najdi More articles by this author , Trong Hieu LeTrong Hieu Le More articles by this author , Tien-Dat HoangTien-Dat Hoang More articles by this author , Khoa QuyKhoa Quy More articles by this author , Ali Sohrab NaushadAli Sohrab Naushad More articles by this author , Mohammed ShahaitMohammed Shahait More articles by this author , Amman JordanAmman Jordan More articles by this author , and David I. LeeDavid I. Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003324.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several centers have reported their recent experiences with the robotic approach in kidney transplantation. Previous reports suggest lower incidence of incisional hernia and lymphocele. However, these reported improvements in perioperative and follow-up outcomes are still debated. This most comprehensive and updated meta-analysis sought to compare the perioperative and follow-up outcomes between robot-assisted kidney transplantation (RAKT) and open kidney transplantation (OKT). METHODS: For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until May 21, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. The risk ratio (RR) and mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI). RESULTS: Of the 1580 retrieved abstracts, 95 underwent full-text review, and 15 studies were included in the final analysis, comprising a total cohort of 2,319 cases of kidney transplantation (667 RAKT and 1,652 OKT). The quality of the studies remains low with large heterogeneity in the cohorts. the RAKT group still has longer warm ischemia time, cold ischemia time, rewarming time, total ischemia time and operative time compared to the OKT group. Even though RAKT group had shorter incision length (RR=1.42, 95%CI (0.350 - 5.766), p=0.623) resulting in lower pain score (MD=-1.37, 95%CI (-1.59 - -1.15), p=<0.001), less morphine use (SMD=-3.478, 95%CI (-5.619 - -1.336), p=0.001), and shorter length of stay (LOS) (SMD=-0.496, 95%CI (-0.819 - -0.173), p=0.003), it has similar clinical estimated blood loss, similar rates of surgical site hernia and postoperative lymphocele. Both techniques have equivalent renal function, graft, and patient survival. Decrease surgical site infection remains only significant in obese patients. CONCLUSIONS: Our study showed that with a larger series and more patients, the initial promise that RAKT have lower rates rate of lymphocele incisional hernia is not true. While RKT does have shorter wound incision, less pain, and LOS, this comes at a cost of longer op times with no improvement in graft survival. The answer to whether RAKT is worthwhile remains to be answered by a randomized controlled study. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e900 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tuan Thanh Nguyen More articles by this author Adnan El-Achkar More articles by this author Berut Lebanon More articles by this author Ho Yee Tiong More articles by this author Ryan W. Dobbs More articles by this author Huy Gia Vuong More articles by this author Jacob Basilius More articles by this author Le Quy Van Dinh More articles by this author Ho Chi Minh More articles by this author Vietnam More articles by this author Jad Najdi More articles by this author Trong Hieu Le More articles by this author Tien-Dat Hoang More articles by this author Khoa Quy More articles by this author Ali Sohrab Naushad More articles by this author Mohammed Shahait More articles by this author Amman Jordan More articles by this author David I. Lee More articles by this author Expand All Advertisement PDF downloadLoading ...