Robotic versus open surgery for ureteroenteric stricture after radical cystectomy: a systematic review and meta-analysis.

Abstract

Ureteroenteric stricture (UES) frequently occurs as a postoperative complication following radical cystectomy, potentially causing severe clinical issues. The aim of this study was to systematically review and meta-analyze to compare the clinical efficacy and safety of robot-assisted ureteroenteric reimplantation (RUER) versus open ureteroenteric reimplantation (OUER) in the treatment of UES. The research was comprehensively explored in the PubMed, Embase, Cochrane Library, and Web of Science databases, covering the timeframe from their inception up to January 17, 2025. The research included quality-evaluated observational studies that compared RUER with OUER for UES. The primary assessment metric was the rate of stenosis recurrence versus reconstruction success. This analysis covered four studies involving a total of 161 participants, with 39 in the OUER cohort and 122 in the RUER cohort. The findings indicated that the RUER cohort experienced a shorter hospital stay than the OUER cohort (RR = - 3.18, 95% CI [- 4.88, - 1.48], p < 0.05). However, there were no notable differences between the two cohorts in terms of stenosis recurrence, reconstruction success, surgical duration, blood loss, intraoperative complications, minor issues, or the incidence of severe complications. RUER has the advantage of shorter hospitalization time than conventional open surgery in the treatment of UES, and both perform comparably in terms of safety. Nevertheless, it is essential to recognize that larger-scale randomized controlled studies are needed to thoroughly validate the reliability of these findings.