{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:45:49Z","timestamp":1787013949586,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T00:00:00Z","timestamp":1703894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare intra\u2010 and postoperative outcomes between off\u2010clamp and on\u2010clamp robot\u2010assisted partial nephrectomy (RAPN), using data from randomised controlled trials (RCTs) or covariate\u2010matched studies (propensity score\u2010matched or matched\u2010pair analysis).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses\u2010compliant literature review was conducted on PubMed, EMBASE, Scopus and CENTRAL for relevant studies comparing off\u2010clamp to on\u2010clamp RAPN. Primary outcomes were estimated blood loss, postoperative percentage decrease in estimated glomerular filtration rate (eGFR), and margin positive rate. Secondary outcomes were operative time, postoperative eGFR, length of stay, all postoperative complications, major complications, and need for transfusion. Random\u2010effects meta\u2010analyses were performed to generate mean differences (MDs) or odds ratios (ORs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 10 studies (2307 patients) were shortlisted for analysis. There was no significant difference in estimated operative blood loss between off\u2010clamp and on\u2010clamp RAPN (MD 21.9\u2009mL, 95% confidence interval [CI] \u22120.9 to 44.7\u2009mL;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.06,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200958%). Off\u2010clamp RAPN yielded a smaller postoperative eGFR deterioration (MD 3.10%, 95% CI 1.05\u20135.16%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200913%) and lower odds of margin positivity (OR 0.62, 95% CI 0.40\u20130.94;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). No significant differences were found for all secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Off\u2010clamp and on\u2010clamp RAPN are similarly effective approaches for selected renal masses. Within the classic trifecta of PN outcomes, off\u2010clamp RAPN yields similar rates of perioperative complications and may possibly offer better preservation of renal function and reduced margin\u2010positive rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16250","type":"journal-article","created":{"date-parts":[[2023,12,9]],"date-time":"2023-12-09T02:14:29Z","timestamp":1702088069000},"page":"375-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Off\u2010clamp vs on\u2010clamp robot\u2010assisted partial nephrectomy: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8194-0800","authenticated-orcid":false,"given":"Khi Yung","family":"Fong","sequence":"first","affiliation":[{"name":"Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6258-3286","authenticated-orcid":false,"given":"Valerie Huei Li","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore Singapore"},{"name":"SingHealth Duke\u2010NUS Transplant Centre  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin Jia Han","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiong Huak","family":"Chan","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Yong Loo Lin School of Medicine National University of Singapore  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7354-9190","authenticated-orcid":false,"given":"Daniele","family":"Castellani","sequence":"additional","affiliation":[{"name":"Urology Unit, Azienda Ospedaliero\u2010Universitaria Delle Marche Universit\u00e0 Politecnica delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3844-7567","authenticated-orcid":false,"given":"Kenneth","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0365-1899","authenticated-orcid":false,"given":"Kae Jack","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry Sun Sien","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Shyi Peng","family":"Yuen","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1512-3356","authenticated-orcid":false,"given":"Edwin","family":"Aslim","sequence":"additional","affiliation":[{"name":"Department of Urology Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-2342","authenticated-orcid":false,"given":"Jeremy","family":"Teoh","sequence":"additional","affiliation":[{"name":"S.H. 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