Abstract:
ObjectiveTo compare the efficacy of robot-assisted laparoscopic surgery and traditional laparoscopic surgery in the treatment of ureteral obstruction through a meta-analysis.
MethodsA comprehensive literature search was conducted in CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Cochrane Library, and Web of Science, covering publications from inception to August 8, 2024. The Chinese and English search terms included “Ureter” “Obstruction” “Robot-Assisted Surgery” and “Robotic Surgical Procedure”. Intraoperative blood loss and other surgical outcomes were compared between the two approaches.
ResultsA total of 30 studies involving 2 314 patients were included. The results of meta-analysis showed that the robotic group had significantly reduced intraoperative blood loss WMD(95%CI)= -5.44 (-10.64, -0.24) mL,
P = 0.040, shorter operative time WMD = -16.47 (-27.49, -5.44) min,
P = 0.003, reduced length of hospital stay WMD =-0.55 (-0.65, -0.45) d,
P < 0.001, shorter duration of drainage tube placement WMD = -1.04 (-1.67, -0.41) d,
P = 0.001, decreased anastomosis time WMD = -11.26 (-21.98, -0.54) min,
P = 0.040, and shorter suture time WMD = -19.72 (-33.76, -5.67) min,
P = 0.006 compared with the traditional laparoscopic group. The robotic group also demonstrated a higher surgical success rate OR = 2.42 (1.36, 4.32),
P = 0.003 and higher hospitalization costs WMD = 33,756.24 (25,689.01, 41,823.47) RMB,
P < 0.001. No significant differences were observed in complication rate OR (95%CI) =0.79 (0.57, 1.09),
P = 0.144, reoperation rate OR (95%CI)=1.13(0.50, 2.55),
P = 0.762, or ureteral stent retention time WMD(95%CI)= 0.00(-1.12,1.13) d,
P = 0.994 between the two groups.
ConclusionRobotic-assisted laparoscopic surgery has been shown to significantly reduce intraoperative blood loss, shorten operative time, hospital stay, drainage duration, anastomosis time, and suturing time, while improving surgical success rates. It is particularly suitable for complex and technically demanding procedures that require precision, offering substantial clinical value despite its relatively high cost.