A mitochondrion-targeted cyanine agent for NIR-II fluorescence-guided surgery combined with intraoperative photothermal therapy to reduce prostate cancer recurrence.

Poorly identified tumor boundaries and nontargeted therapies lead to the high recurrence rates and poor quality of life of prostate cancer patients. Near-infrared-II (NIR-II) fluorescence imaging provides certain advantages, including high resolution and the sensitive detection of tumor boundaries. Herein, a cyanine agent (CY7-4) with significantly greater tumor affinity and blood circulation time than indocyanine green was screened. By binding albumin, the absorbance of CY7-4 in an aqueous solution showed no effects from aggregation, with a peak absorbance at 830 nm and a strong fluorescence emission tail beyond 1000 nm. Due to its extended circulation time (half-life of 2.5 h) and high affinity for tumor cells, this fluorophore was used for primary and metastatic tumor diagnosis and continuous monitoring. Moreover, a high tumor signal-to-noise ratio (up to ~ 10) and excellent preferential mitochondrial accumulation ensured the efficacy of this molecule for photothermal therapy. Therefore, we integrated NIR-II fluorescence-guided surgery and intraoperative photothermal therapy to overcome the shortcomings of a single treatment modality. A significant reduction in recurrence and an improved survival rate were observed, indicating that the concept of intraoperative combination therapy has potential for the precise clinical treatment of prostate cancer.

Circularly polarized light emission and detection by chiral inorganic semiconductors.

Chiral inorganic semiconductors with high dissymmetric factor are highly desirable, but it is generally difficult to induce chiral structure in inorganic semiconductors because of their structure rigidity and symmetry. In this study, we introduced chiral ZnO film as hard template to transfer chirality to CsPbBr3 film and PbS quantum dots (QDs) for circularly polarized light (CPL) emission and detection, respectively. The prepared CsPbBr3/ZnO thin film exhibited CPL emission at 520 nm and the PbS QDs/ZnO film realized CPL detection at 780 nm, featuring high dissymmetric factor up to around 0.4. The electron transition based mechanism is responsible for chirality transfer.

A temporal enhanced semi-supervised training framework for needle segmentation in 3D ultrasound images.

Objective.Automated biopsy needle segmentation in 3D ultrasound images can be used for biopsy navigation, but it is quite challenging due to the low ultrasound image resolution and interference similar to the needle appearance. For 3D medical image segmentation, such deep learning networks as convolutional neural network and transformer have been investigated. However, these segmentation methods require numerous labeled data for training, have difficulty in meeting the real-time segmentation requirement and involve high memory consumption.Approach.In this paper, we have proposed the temporal information-based semi-supervised training framework for fast and accurate needle segmentation. Firstly, a novel circle transformer module based on the static and dynamic features has been designed after the encoders for extracting and fusing the temporal information. Then, the consistency constraints of the outputs before and after combining temporal information are proposed to provide the semi-supervision for the unlabeled volume. Finally, the model is trained using the loss function which combines the cross-entropy and Dice similarity coefficient (DSC) based segmentation loss with mean square error based consistency loss. The trained model with the single ultrasound volume input is applied to realize the needle segmentation in ultrasound volume.Main results.Experimental results on three needle ultrasound datasets acquired during the beagle biopsy show that our approach is superior to the most competitive mainstream temporal segmentation model and semi-supervised method by providing higher DSC (77.1% versus 76.5%), smaller needle tip position (1.28 mm versus 1.87 mm) and length (1.78 mm versus 2.19 mm) errors on the kidney dataset as well as DSC (78.5% versus 76.9%), needle tip position (0.86 mm versus 1.12 mm) and length (1.01 mm versus 1.26 mm) errors on the prostate dataset.Significance.The proposed method can significantly enhance needle segmentation accuracy by training with sequential images at no additional cost. This enhancement may further improve the effectiveness of biopsy navigation systems.

TransVFS: A spatio-temporal local-global transformer for vision-based force sensing during ultrasound-guided prostate biopsy.

Robot-assisted prostate biopsy is a new technology to diagnose prostate cancer, but its safety is influenced by the inability of robots to sense the tool-tissue interaction force accurately during biopsy. Recently, vision based force sensing (VFS) provides a potential solution to this issue by utilizing image sequences to infer the interaction force. However, the existing mainstream VFS methods cannot realize the accurate force sensing due to the adoption of convolutional or recurrent neural network to learn deformation from the optical images and some of these methods are not efficient especially when the recurrent convolutional operations are involved. This paper has presented a Transformer based VFS (TransVFS) method by leveraging ultrasound volume sequences acquired during prostate biopsy. The TransVFS method uses a spatio-temporal local-global Transformer to capture the local image details and the global dependency simultaneously to learn prostate deformations for force estimation. Distinctively, our method explores both the spatial and temporal attention mechanisms for image feature learning, thereby addressing the influence of the low ultrasound image resolution and the unclear prostate boundary on the accurate force estimation. Meanwhile, the two efficient local-global attention modules are introduced to reduce 4D spatio-temporal computation burden by utilizing the factorized spatio-temporal processing strategy, thereby facilitating the fast force estimation. Experiments on prostate phantom and beagle dogs show that our method significantly outperforms existing VFS methods and other spatio-temporal Transformer models. The TransVFS method surpasses the most competitive compared method ResNet3dGRU by providing the mean absolute errors of force estimation, i.e., 70.4 ± 60.0 millinewton (mN) vs 123.7 ± 95.6 mN, on the transabdominal ultrasound dataset of dogs.

In Situ Mitochondrial Biomineralization for Drug-Free Cancer Therapy.

The common clinical chemotherapy often brings serious side effects to patients, mainly due to the off-target and leakage of toxic drugs. However, this is fatal for some specific clinical tumors, such as brain tumors and neuroma. This study performs a drug-free approach by encapsulating black phosphorus (BP) and calcium peroxide (CaO2) in liposomes with surface-modified triphenylphosphonium (BCLT) to develop mitochondria targeting calcification for cancer therapy without damaging normal cells. BCLT preferentially accumulates inside tumor mitochondria and then is activated by near-infrared (NIR) laser irradiation to produce abundant PO4 3- and Ca2+ to accelerate in situ mitochondrial mineralization, leading to mitochondrial dysfunction and cancer cell death. More importantly, both PO4 3- and Ca2+ are essential components of metabolism in the body, and random gradient diffusion or premature leakage does not cause damage to adjacent normal cells. This achievement promises to be an alternative to conventional chemotherapy in clinical practice for many specific tumor types.

Amorphous Albumin Gadolinium-Based Nanoparticles for Ultrahigh-Resolution Magnetic Resonance Angiography.

Magnetic resonance angiography (MRA) contrast agents are extensively utilized in clinical practice due to their capability of improving the image resolution and sensitivity. However, the clinically approved MRA contrast agents have the disadvantages of a limited acquisition time window and high dose administration for effective imaging. Herein, albumin-coated gadolinium-based nanoparticles (BSA-Gd) were meticulously developed for in vivo ultrahigh-resolution MRA. Compared to Gd-DTPA, BSA-Gd exhibits a significantly higher longitudinal relaxivity (r1 = 76.7 mM-1 s-1), nearly 16-fold greater than that of Gd-DTPA, and an extended blood circulation time (t1/2 = 40 min), enabling a dramatically enhanced high-resolution imaging of microvessels (sub-200 µm) and low dose imaging (about 1/16 that of Gd-DTPA). Furthermore, the clinically significant fine vessels were successfully mapped in large mammals, including a circle of Willis, kidney and liver vascular branches, tumor vessels, and differentiated arteries from veins using dynamic contrast-enhanced MRA BSA-Gd, and have superior imaging capability and biocompatibility, and their clinical applications hold substantial promise.

Finite-time adaptive super-twisting sliding mode control for autonomous robotic manipulators with actuator faults.

This paper proposes a new adaptive super-twisting global integral terminal sliding mode control algorithm for the trajectory tracking of autonomous robotic manipulators with uncertain parameters, unknown disturbances, and actuator faults. Firstly, a novel global integral terminal sliding mode surface is designed to ensure that the tracking errors of autonomous robotic manipulators converge to zero in finite time and the global robustness of the system is also enhanced. Then a new adaptive method is devised to deal with the adverse effect of nonlinear uncertainty. To suppress the chattering phenomenon, the adaptive super-twisting algorithm is used in this paper, which can ensure that the control torque is a continuous input signal. Based on the adaptive mechanism, the adaptive super-twisting global integral terminal sliding mode controller is developed to provide superior control performance. The stability analysis of the system is demonstrated by using the Lyapunov method. Ultimately, the effectiveness of the control scheme is confirmed by a simulation study.

Natural bioactive lysosomes extracted from multiple cells for tumor therapy.

Nanoparticles of biological origin exhibit many unique properties in biological applications due to their exquisite structure, specific composition, and natural biological functionality. In this study, we obtained lysosomes from three distinct cell types (one normal cell and two activated immune cells) and demonstrated their potential as natural therapeutic nanoparticles for tumor therapy. In vitro experiments revealed that these lysosomes maintained their structural integrity, were well-distributed, and exhibited significant biological activity, which effectively induced cancer cell death by generating ROS and disrupting biological substrates. Additionally, in vivo investigations showed that these lysosomes could accumulate in tumor tissues after intravenous administration and exhibited exceptional therapeutic effects through the destruction of tumor blood vessels and the degradation of immunosuppressive proteins, with complete tumor disappearance in a single treatment. This research on the utilization of bioactive lysosomes for tumor treatment provides valuable insights into drug development and tumor treatment, particularly when conventional approaches have proven ineffective.

circRARS synergises with IGF2BP3 to regulate RNA methylation recognition to promote tumour progression in renal cell carcinoma.

As the most prominent RNA modification, N6-methyladenosine (m6 A) participates in the regulation of tumour initiation and progression. Circular RNAs (circRNAs) also play crucial roles in ubiquitous life processes. Whether circRNAs are required for m6 A regulation in renal cell carcinoma (RCC) remains unclear. Meta-analysis and bioinformatics identified that IGF2BP3 was upregulated in RCC and indicated a worse prognosis. IGF2BP3 significantly promoted RCC progression in vitro and in vivo. Mechanistically, circRARS bound to KH1-KH2 domains of IGF2BP3 to enhance m6 A modification recognition. A 12-nt sequence (GUCUUCCAGCAA) was proven to be the IGF2BP3-binding site of circRARS. Additionally, CAPN15, CD44, HMGA2, TNRC6A and ZMIZ2 were screened to be the target genes regulated by the IGF2BP3/circRARS complex in an m6 A-dependent manner. Stabiliser proteins, including HuR, Matrin3 and pAbPC1, were recruited by circRARS, thereby increasing the mRNA stability of the forementioned five target genes. Consequently, the IGF2BP3/circRARS complex facilitated the lipid accumulation of RCC cells and promoted sunitinib resistance via target genes. circRARS synergised with IGF2BP3 to facilitate m6 A recognition, thereby promoting RCC progression. Thus, IGF2BP3 could be a potential biomarker for RCC diagnosis and prognosis and a therapeutic target.

Preliminary evaluation for ultrasound-guided targeted prostate biopsy using a portable surgical robot: Ex vivo results.

BACKGROUND: Robotic systems are increasingly used to enhance clinical outcomes in prostate intervention. To evaluate the clinical value of the proposed portable robot, the robot-assisted and robot-targeted punctures were validated experimentally. METHOD: The robot registration utilising the electromagnetic tracker achieves coordinate transformation from the ultrasound (US) image to the robot. Subsequently, Transrectal ultrasound (TRUS)-guided phantom trials were conducted for robot-assisted, free-hand, and robot-targeted punctures. RESULTS: The accuracy of robot registration was 0.95 mm, and the accuracy of robot-assisted, free-hand, and robot-targeted punctures was 2.38 ± 0.64 mm, 3.11 ± 0.72 mm, and 3.29 ± 0.83 mm sequentially. CONCLUSION: The registration method has been successfully applied to robot-targeted puncture. Current results indicate that the accuracy of robot-targeted puncture is slightly inferior to that of manual operations. Moreover, in manual operation, robot-assisted puncture improves the accuracy of free-hand puncture. Accuracy superior to 3.5 mm demonstrates the clinical applicability of both robot-assisted and robot-targeted punctures.

Elevating Second Near-Infrared Photothermal Conversion Efficiency of Hollow Gold Nanorod for a Precise Theranostic of Orthotopic Bladder Cancer.

The second near-infrared (NIR-II) window laser-activated agents have attracted broad interest in an orthotopic cancer theranostic. However, developing NIR-II photothermal agents (PTAs) with advanced photothermal conversion efficiency (PTCE) and tumor-specific response elevation remains a crucial challenge. Herein, a hollow gold nanorod (AuHNR) with a strong localized surface plasmon resonance (LSPR) peak in the NIR-II window was coated with MnO2 and chitosan to obtain AuHNR@MnO2@CS (termed AuMC) by a one-step method. Upon exposure to the tumor microenvironment (TME), the overexpressed GSH triggered degradation of the MnO2 layer to release Mn2+ and resulted in the PTCE elevation owing to exposure of the AuHNR. Consequently, photoacoustic and magnetic resonance imaging for accurate diagnosis, Mn2+-mediated chemodynamic therapy, and AuHNR elevating PT therapy for precise treatment could be achieved. Both in vitro and in vivo experiments confirmed the good performance of the AuMC on an orthotopic bladder cancer precise theranostic. This study provided NIR-II activated, TME-response PT conversion efficiency enhanced PTAs and offered a tumor-selective theranostic agent for orthotopic bladder cancer in clinical application.

The m6A modification-mediated OGDHL exerts a tumor suppressor role in ccRCC by downregulating FASN to inhibit lipid synthesis and ERK signaling.

Metabolic reprogramming is a hallmark of cancer, and the impact of lipid metabolism as a crucial aspect of metabolic reprogramming on clear cell renal cell carcinoma (ccRCC) progression has been established. However, the regulatory mechanisms underlying the relationship between metabolic abnormalities and ccRCC progression remain unclear. Therefore, this study aimed to identify key regulatory factors of metabolic reprogramming in ccRCC and provide potential therapeutic targets for ccRCC patients. Potential metabolic regulatory factors in ccRCC were screened using bioinformatics analysis. Public databases and patient samples were used to investigate the aberrant expression of Oxoglutarate dehydrogenase-like (OGDHL) in ccRCC. The function of OGDHL in ccRCC growth and metastasis was evaluated through in vitro and in vivo functional experiments. Mechanistic insights were obtained through luciferase reporter assays, chromatin immunoprecipitation, RNA methylation immunoprecipitation, and mutagenesis studies. OGDHL mRNA and protein levels were significantly downregulated in ccRCC tissues. Upregulation of OGDHL expression effectively inhibited ccRCC growth and metastasis both in vitro and in vivo. Furthermore, FTO-mediated OGDHL m6A demethylation suppressed its expression in ccRCC. Mechanistically, low levels of OGDHL promoted TFAP2A expression by inhibiting ubiquitination levels, which then bound to the FASN promoter region and transcriptionally activated FASN expression, thereby promoting lipid accumulation and ERK pathway activation. Our findings demonstrate the impact of OGDHL on ccRCC progression and highlight the role of the FTO/OGDHL/TFAP2A/FASN axis in regulating ccRCC lipid metabolism and progression, providing new targets for ccRCC therapy.

Personal Microenvironment Management by Smart Textiles with Negative Oxygen Ions Releasing and Radiative Cooling Performance.

In recent years, significant strides have been made in the development of smart clothing, which combines traditional apparel with advanced technology. As our climate and environment undergo continuous changes, it has become critically important to invent and refine sophisticated textiles that enhance thermal comfort and human health. In this study, we present a "wearable forest-like textile". This textile is based on helical lignocellulose-tourmaline composite fibers, boasting mechanical strength that outperforms that of cellulose-based and natural macrofibers. This wearable microenvironment does more than generate approximately 18625 ions/cm3 of negative oxygen ions; it also effectively purifies particulate matter. Furthermore, our experiments demonstrate that the negative oxygen ion environment can slow fruit decay by neutralizing free radicals, suggesting promising implications for aging retardation. In addition, this wearable microenvironment reflects solar irradiation and selectively transmits human body thermal radiation, enabling effective radiative cooling of approximately 8.2 °C compared with conventional textiles. This sustainable and efficient wearable microenvironment provides a compelling textile choice that can enhance personal heat management and human health.

A Novel Three-Channel Endorectal Coil for Prostate Magnetic Resonance Imaging at 3T.

OBJECTIVE: The purpose of this work is to develop a 3-channel endorectal coil (ERC-3C) structure to obtain higher signal-to-noise (SNR) and better parallel imaging performance for prostate magnetic resonance imaging (MRI) at 3T. METHODS: The coil performance was validated by in vivo studies and the SNR, g-factor, and diffusion-weighted imaging (DWI) were compared. A 2-channel endorectal coil (ERC-2C) with two orthogonal loops and a 12-channel external surface coil were employed for comparison. RESULTS: Compared with the ERC-2C with a quadrature configuration and the external 12-channel coil array, the proposed ERC-3C improved SNR performance by 23.9% and 428.9%, respectively. The improved SNR enables the ERC-3C to produce spatial high-resolution images of 0.24 mm × 0.24 mm × 2 mm (0.1152 µL) in the prostate area within 9 minutes. CONCLUSION: We developed an ERC-3C and validated its performance through in vivo MR imaging experiments. SIGNIFICANCE: The results demonstrated the feasibility of an ERC with more than two channels and that a higher SNR can be achieved using the ERC-3C compared with an orthogonal ERC-2C of the same coverage.

Successful experiences and feasible techniques of robotic-assisted inferior vena cava filter retrieval after failure of endovascular attempts: a case report.

Background: The mainstay of inferior vena cava (IVC) filter retrieval has been snare techniques. However, caval penetration or filter fracture makes endovascular approaches challenging, which in turn leads to more aggressive attempts, including open surgical procedures. The fact that laparoscopic approaches (especially the da Vinci robotic system) with minimal invasion allow for equivalent long-term outcomes as compared with open procedures is encouraging. To date, few centers have attempted secondary minimal invasive operation after filter retrieval failure. In this study, we presented a case of robot-assisted filter retrieval after failure of snare techniques. The operative time was 55 minutes, which was the shortest time reported in the collected studies thus far. Case Description: A 27-year-old female was diagnosed with deep vein thrombosis after delivery and placement of an IVC filter. Local surgeons tried endovascular approaches to retrieve the filter, but failed twice. She was then transferred to our hospital and computed tomography venography revealed that the filter struts had protruded outside the cava wall. Based on our previous experiences of robotic surgery with vena cava graft replacement, we decided to perform robotic-assisted filter retrieval. The operation was successful, and the estimated blood loss was less than 50 mL. The patient was discharged 5 days after the operation and presented for reexamination 6 months later. Ultrasound showed that the IVC blood flow was smooth. No complications occurred, and the renal function was nearly normal. Conclusions: Filter retrieval failure through the endovascular approach is challenging, and occasionally, open surgery is needed as a second attempt. With the advancement of laparoscopic approaches, especially the enhanced ergonomics of the robotic system, aggressive operation can be avoided, and robotic-assisted filter retrieval can offer an alternative for surgeons to manage these issues.

Single-dye NIR-II chemiluminescence system for H2O2 imaging.

An efficient single-dye NIR-II CL system was proposed for the first time with the longest emission peak around 1000 nm. Biocompatible CL nanoparticles were developed and a surprising CL intensity enhancement was found in the presence of the BASZn nanoenzyme by about three orders of magnitude. Such an NIR-II CL system was demonstrated for glucose sensing, tumor therapy and in vivo H2O2 imaging. Via theoretical and experimental analyses, a novel electron transfer model was established for such a chemiluminescence system rather than the generally considered HOMODye-LUMODOD model. These findings provide useful guidelines for designing efficient single-dye NIR-II CL systems.

Hot Spot Engineering in Hierarchical Plasmonic Nanostructures.

The controllable nanogap structures offer an effective way to obtain strong and tunable localized surface plasmon resonance (LSPR). A novel hierarchical plasmonic nanostructure (HPN) is created by incorporating a rotating coordinate system into colloidal lithography. In this nanostructure, the hot spot density is increased drastically by the long-range ordered morphology with discrete metal islands filled in the structural units. Based on the Volmer-Weber growth theory, the precise HPN growth model is established, which guides the hot spot engineering for improved LSPR tunability and strong field enhancement. The hot spot engineering strategy is examined by the application of HPNs as the surface-enhanced Raman spectroscopy (SERS) substrate. It is universally suitable for various SERS characterization excited at different wavelengths. Based on the HPN and hot spot engineering strategy, single-molecule level detection and long-range mapping can be realized simultaneously. In that sense, it offers a great platform and guides the future design for various LSPR applications like surface-enhanced spectra, biosensing, and photocatalysis.

Flexible Point-of-Care Electrodes for Ultrasensitive Detection of Bladder Tumor-Relevant miRNA in Urine.

Portable point-of-care testing (POCT) is currently drawing enormous attention owing to its great potential for disease diagnosis and personal health management. Electrochemical biosensors, with the intrinsic advantages of cost-effectiveness, fast response, ease of miniaturization, and integration, are considered as one of the most promising candidates for POCT application. However, the clinical application of electrochemical biosensors-based POCT is hindered by the decreased detection sensitivity due to the low abundance of disease-relevant biomolecules in extremely complex biological samples. Herein, we construct a flexible electrochemical biosensor based on single-stranded DNA functionalized single-walled carbon nanotubes (ssDNA-SWNTs) for high sensitivity and stability detection of miRNA-21 in human urine to achieve bladder cancer (BCa) diagnosis and classification. The ssDNA-SWNT electrodes with a 2D interconnected network structure exhibit a high electrical conductivity, thus enabling the ultrasensitive detection of miRNA-21 with a detection limit of 3.0 fM. Additionally, the intrinsic flexibility of ssDNA-SWNT electrodes endows the biosensors with the capability to achieve high stability detection of miRNA-21 even under large bending deformations. In a cohort of 40 BCa patients at stages I-III and 44 negative control samples, the constructed ssDNA-SWNT biosensors could detect BCa with a 92.5% sensitivity, an 88.6% specificity, and classify the cancer stages with an overall accuracy of 81.0%. Additionally, the flexible ssDNA-SWNT biosensors could also be utilized for treatment efficiency assessment and cancer recurrence monitoring. Owing to their excellent sensitivity and stability, the designed flexible ssDNA-SWNT biosensors in this work propose a strategy to realize point-of-care detection of complex clinical samples to achieve personalized healthcare.

NIR-II-triggered doxorubicin release for orthotopic bladder cancer chemo-photothermal therapy.

Intravesical instillation has been widely utilized for bladder cancer treatment in clinic. However, due to the bladder mucosal barrier, its poor penetration efficiency and drug utilization limit the clinical therapeutic effectiveness and result in a high recurrence rate. Therefore, designing an efficient and controllable drug delivery nanoplatform is of great significance for bladder cancer treatment. Non-invasive therapy based on near-infrared-II (NIR-II) photothermal therapy (PTT) conduces to overcome bladder mucosal barrier and enhance drug delivery. Also, the photothermal nanomaterials, Au Hollow Nanorods (AuHNRs), demonstrate strong photothermal properties and drug loading capacity. Herein, a quaternized chitosan N-(2-hydroxyl)propyl-3-trimethyl ammonium chitosan chloride (HTCC)-modified nanocarrier Dox/NH4HCO3@AuHNRs-HTCC (DNAH) was designed for controlled drug release and enhanced penetration. The drug loading capacity of DNAH reached 117.20%. Also, the thermal decomposition of NH4HCO3 realized NIR-II-triggered gas-driven drug burst release, and the doxorubicin release was 2.79 times higher within 1 h after NIR-II irradiation. Also, the HTCC-modified nanocarriers significantly enhanced the bladder mucosal permeability as well as long-term drug retention, and the penetration efficiency of DNAH increased by 144%. In the orthotopic bladder cancer model, the tumor suppression rate and mouse survival time were significantly improved. DNAH showed potent inhibition of the orthotopic bladder tumor growth owing to the enhanced penetration and drug delivery. This work presents a potential drug delivery nanocarrier, which is promising for optimized bladder mucosal permeability and controlled drug burst release.

Robotic-assisted versus standard laparoscopic radical cystectomy in bladder cancer: A systematic review and meta-analysis.

Background: This study aimed to evaluate the efficacy and safety of robotic-assisted radical cystectomy (RARC) versus laparoscopic radical cystectomy (LRC) in the treatment of bladder cancer. Methods: Two researchers independently searched PubMed, Embase, Cochrane, and CBM using the index words to identify the qualified studies which included randomized controlled trials (RCTs) and non-randomized controlled trials (prospective and retrospective studies), and the investigators scanned references of these articles to prevent missing articles. Differences in clinical outcomes between the two procedures were analyzed by calculating odds risk (OR) and mean difference (MD) with an associated 95% confidence interval (CI). Results: Sixteen comparative studies were included in the meta-analysis with 1467 patients in the RARC group and 897 patients in the LRC group. The results indicated that RARC could significantly decrease blood loss (P = 0.01; MD: -82.56, 95% CI: -145.04 to -20.08), and complications 90 days or more after surgery, regardless of whether patients were Grade ≤ II (P = 0.0008; OR: 0.63, 95% CI: 0.48 to 0.82) or Grade ≥ III (P = 0.006; OR: 0.59, 95% CI: 0.40 to 0.86), as well as overall complications (P: 0.01; OR = 0.52; 95% CI: 0.32 to 0.85). However, there was no statistical difference between the two groups at total operative time, intraoperative complications, transfusion rate, short-term recovery, hospital stay, complications within 30 days of surgery, and bladder cancer-related mortality. Conclusions: The meta-analysis demonstrates that RARC is a safe and effective treatment for bladder cancer, like LRC, and patients with RARC benefit from less blood loss and fewer long-term complications related to surgery, and should be considered a viable alternative to LRC. There still need high-quality, larger sample, multi-centric, long-term follow-up RCTs to confirm our conclusion.