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Complications and health-related quality of life after robot-assisted versus open radical cystectomy : A systematic review and meta-analysis of four RCTs

Lauridsen, Susanne Vahr; Tønnesen, Hanne LU ; Jensen, Bente Thoft; Neuner, Bruno; Thind, Peter and Thomsen, Thordis LU (2017) In Systematic Reviews 6(1).
Abstract

Background: Radical cystectomy is associated with high rates of perioperative morbidity. Robotic-assisted radical cystectomy (RARC) is widely used today despite limited evidence for clinical superiority. The aim of this review was to evaluate the effect of RARC compared to open radical cystectomy (ORC) on complications and secondary on length of stay, time back to work and health-related quality of life (HRQoL). Methods: The databases PubMed, The Cochrane Library, Embase and CINAHL were searched. A systematic review according to the PRISMA guidelines and cumulative analysis was conducted. Randomized controlled trials (RCTs) that examined RARC compared to ORC were included in this review. We assessed the quality of evidence using the... (More)

Background: Radical cystectomy is associated with high rates of perioperative morbidity. Robotic-assisted radical cystectomy (RARC) is widely used today despite limited evidence for clinical superiority. The aim of this review was to evaluate the effect of RARC compared to open radical cystectomy (ORC) on complications and secondary on length of stay, time back to work and health-related quality of life (HRQoL). Methods: The databases PubMed, The Cochrane Library, Embase and CINAHL were searched. A systematic review according to the PRISMA guidelines and cumulative analysis was conducted. Randomized controlled trials (RCTs) that examined RARC compared to ORC were included in this review. We assessed the quality of evidence using the Cochrane Collaboration's 'Risk of bias' tool and Grading of Recommendations Assessment, Development and Evaluation approach. Data were extracted and analysed. Results: The search retrieved 273 articles. Four RCTs were included involving overall 239 patients. The quality of the evidence was of low to moderate quality. There was no significant difference between RARC and ORC in the number of patients developing complications within 30 or 90 days postoperatively or in overall grade 3-5 complications within 30 or 90 days postoperatively. Types of complications differed between the RARC and the ORC group. Likewise, length of stay and HRQoL at 3 and 6 months did not differ. Conclusion: Our review presents evidence for RARC not being superior to ORC regarding complications, LOS and HRQoL. High-quality studies with consistent registration of complications and patient-related outcomes are warranted. Systematic review registration: PROSPERO CRD42016038232.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clavien-Dindo classification, Health-related quality of life, Open radical cystectomy, Postoperative complications, Robot-assisted radical cystectomy
in
Systematic Reviews
volume
6
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85026640825
ISSN
2046-4053
DOI
10.1186/s13643-017-0547-y
language
English
LU publication?
yes
id
6499a51e-fab2-40e8-8589-9369450f7804
date added to LUP
2017-08-21 13:17:59
date last changed
2017-08-22 03:00:03
@article{6499a51e-fab2-40e8-8589-9369450f7804,
  abstract     = {<p>Background: Radical cystectomy is associated with high rates of perioperative morbidity. Robotic-assisted radical cystectomy (RARC) is widely used today despite limited evidence for clinical superiority. The aim of this review was to evaluate the effect of RARC compared to open radical cystectomy (ORC) on complications and secondary on length of stay, time back to work and health-related quality of life (HRQoL). Methods: The databases PubMed, The Cochrane Library, Embase and CINAHL were searched. A systematic review according to the PRISMA guidelines and cumulative analysis was conducted. Randomized controlled trials (RCTs) that examined RARC compared to ORC were included in this review. We assessed the quality of evidence using the Cochrane Collaboration's 'Risk of bias' tool and Grading of Recommendations Assessment, Development and Evaluation approach. Data were extracted and analysed. Results: The search retrieved 273 articles. Four RCTs were included involving overall 239 patients. The quality of the evidence was of low to moderate quality. There was no significant difference between RARC and ORC in the number of patients developing complications within 30 or 90 days postoperatively or in overall grade 3-5 complications within 30 or 90 days postoperatively. Types of complications differed between the RARC and the ORC group. Likewise, length of stay and HRQoL at 3 and 6 months did not differ. Conclusion: Our review presents evidence for RARC not being superior to ORC regarding complications, LOS and HRQoL. High-quality studies with consistent registration of complications and patient-related outcomes are warranted. Systematic review registration: PROSPERO CRD42016038232.</p>},
  articleno    = {150},
  author       = {Lauridsen, Susanne Vahr and Tønnesen, Hanne and Jensen, Bente Thoft and Neuner, Bruno and Thind, Peter and Thomsen, Thordis},
  issn         = {2046-4053},
  keyword      = {Clavien-Dindo classification,Health-related quality of life,Open radical cystectomy,Postoperative complications,Robot-assisted radical cystectomy},
  language     = {eng},
  month        = {08},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Systematic Reviews},
  title        = {Complications and health-related quality of life after robot-assisted versus open radical cystectomy : A systematic review and meta-analysis of four RCTs},
  url          = {http://dx.doi.org/10.1186/s13643-017-0547-y},
  volume       = {6},
  year         = {2017},
}