Robotic radical hysterectomy is not superior to laparoscopic radical hysterectomy in perioperative urologic complications: A meta-analysis of 23 studies

ABSTRACT OBJECTIVE This study aimed to compare the risks of intraoperative and postoperative urologic complications after robotic radical hysterectomy (RRH) compared with laparoscopic radical hysterectomy (LRH). DATA SOURCES We searched Pubmed, EMBASE, and the Cochrane Library for studies published up to March 2019. Related articles and relevant bibliographies of published studies were also checked. METHODS OF STUDY SELECTION Two researchers independently performed data extraction. We selected comparative studies that reported perioperative urologic complications. TABULATION, INTEGRATION, AND RESULTS A total of 23 eligible clinical trials were included in this analysis. When all studies were pooled, the odds ratio (OR) for the risk of any urologic complication after RRH compared with LRH was 0.91 (95% confidence interval [CI]: 0.64-1.28, p  = 0.585). The OR for intraoperative and postoperative complications after RRH versus LRH was 0.86 (95% CI: 0.48-1.55, p  = 0.637) and 0.94 (95 % CI: 0.64-1.38, p  = 0.767), respectively. In a secondary analysis, study quality, study location, and the publication year were not associated with intraoperative or postoperative urologic complications. CONCLUSION Current evidence suggests that RRH is not superior to LRH in terms of perioperative urologic complications.