The Outcome of Sutureless in Partial Nephrectomy: A Systematic Review and Meta-Analysis

Abstract

Purpose. To compare the effect of sutureless versus standard suture (double-layer suture) during renorrhaphy in laparoscopic or robotic-assisted partial nephrectomy on perioperative and renal function outcomes. Methods. PubMed, Embase, and other sources were searched for randomized controlled trials or retrospective studies comparing sutureless partial nephrectomy versus standard suture partial nephrectomy. A systematic review and meta-analysis were performed by two reviewers independently. Results. Five retrospective studies were included with a total of 634 patients. The results showed that there was a significant difference in the decline of estimated glomerular filtration rate ( $I^2=98.5\%$ ; WMD, -4.19 ml/min; 95% CI, -7.64 to -0.73; $P<0.001$ ) and no significant difference in postoperative complications ( $I^2=0$ ; RR, 1.31; 95% CI, 0.61 to 2.81; $P=0.623$ ). A significant advantage in terms of operating time ( $I^2=53.9\%$ ; WMD, -29.08 min; 95% CI, -33.06 to -25.10; $P=0.069$ ) and warm ischemia time ( $I^2=38.5\%$ ; WMD, -6.17 min; 95% CI, -6.99 to -5.36; $P=0.165$ ) favored sutureless, while there was no significant difference in blood loss ( $I^2=58.1\%$ ; WMD, 3.10 ml; 95% CI, -39.18 to 45.38; $P=0.049$ ). Conclusion. Sutureless during renorrhaphy is feasible and safe compared with standard suture. Sutureless can shorten the operating time and warm ischemia time without increasing postoperative complications, and thus, it protects renal function.