Comparing the outcomes of robotic vs. open partial nephrectomy in obese patients: a meta-analysis and systematic review.

Abstract

This meta-analysis examines and compares the perioperative results (such as complications, recovery, and other surgical outcomes) in obese patients who undergo either robotic-assisted partial nephrectomy (RPN) or open partial nephrectomy (OPN). Essentially, the study is looking at how these two types of surgeries perform in obese patients, specifically focusing on outcomes related to the surgery process itself. We conducted a comprehensive search of major databases, including PubMed, Cochrane Library, and Web of Science, focusing on English studies, up to November 2024. Review articles, research protocols without published data, conference abstracts, and irrelevant studies were excluded. We performed data analysis using the Cochran-Mantel-Haenszel method and random-effects models, followed by mean differences, inverse variance, and 95% confidence intervals (CIs). The results were presented as odds ratios (ORs) and 95% CIs, and data with p values less than 0.05 were identified. This meta-analysis included three cohort studies with a total of 604 patients. Compared to OPN, RPN was associated with significantly shorter hospital stays (WMD  - 2.27, 95% CI  - 3.67 to  - 0.87; p = 0.002), lower overall complication rates (OR 0.50, 95% CI 0.34-0.73; p = 0.0004), and reduced estimated blood loss (WMD  - 125.12, 95% CI  - 198.02 to  - 52.22; p = 0.0008). No significant differences were found between the two groups in transfusion rates, major complications, renal ischemia times, or operative times. RPN offers a safe and feasible option for obese patients compared to OPN, with advantages such as shorter hospital stays, reduced blood loss, and fewer overall complications.