Comparison of perioperative outcomes of selective arterial clipping guided by near-infrared fluorescence imaging using indocyanine green versus undergoing standard robotic-assisted partial nephrectomy: a systematic review and meta-analysis

<jats:sec> <jats:title>Background:</jats:title> <jats:p>This study employs a meta-analytic approach to investigate the impact of robotic-assisted partial nephrectomy, with and without near-infrared fluorescence imaging (NIRF-RAPN vs S-RAPN), on patients’ perioperative outcomes and postoperative changes in renal function.</jats:p> </jats:sec> <jats:sec> <jats:title>Materials and methods:</jats:title> <jats:p>The authors conducted a comprehensive and rigorous systematic review and cumulative meta-analysis of primary outcomes following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), AMSTAR (Assessing the Methodological Quality of Systematic Reviews) Guidelines, and Risk-of-Bias Tool (RoB2). To ensure a thorough search, the authors systematically searched five major databases, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science, from databases’ inception to April 2023.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>No significant differences were found between the two groups in terms of age (<jats:italic toggle="yes">P</jats:italic>=0.19), right side (<jats:italic toggle="yes">P</jats:italic>=0.54), BMI (<jats:italic toggle="yes">P</jats:italic>=0.39), complexity score (<jats:italic toggle="yes">P</jats:italic>=0.89), tumor size (<jats:italic toggle="yes">P</jats:italic>=0.88), operating time (<jats:italic toggle="yes">P</jats:italic>=0.39), estimated blood loss (<jats:italic toggle="yes">P</jats:italic>=0.47), length of stay (<jats:italic toggle="yes">P</jats:italic>=0.87), complications (<jats:italic toggle="yes">P</jats:italic>=0.20), transfusion (<jats:italic toggle="yes">P</jats:italic>=0.36), and positive margins (<jats:italic toggle="yes">P</jats:italic>=0.38). However, it is noteworthy that the NIRF-RAPN group exhibited significant reductions in warm ischemia time (<jats:italic toggle="yes">P</jats:italic>=0.001), the percentage change in estimated glomerular filtration rate at discharge (<jats:italic toggle="yes">P</jats:italic>=0.01) compared to the S-RAPN group.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>This meta-analysis provides evidence that the group undergoing NIRF-RAPN showed a statistically significant protective effect on the estimated glomerular filtration rate (eGFR).</jats:p> </jats:sec>