Comparison of efficacy and safety of conventional laparoscopic radical prostatectomy by the transperitoneal versus extraperitoneal procedure

Worldwide, prostate cancer (PCa) is the second most common malignancy in males. We undertook a meta-analysis to compare the efficacy and safety of conventional laparoscopic radical prostatectomy with a transperitoneal (TLRP) approach, versus that of an extraperitoneal (ELRP) approach, for treatment of localized PCa. A comprehensive literature search retrieved 14 publications, with a total of 1715 patients. Meta-analysis of these studies showed that an ELRP approach was associated with a significantly shorter postoperative catheterization time (MD: 1.99; 95% CI: 0.52 to 3.54; P = 0.008), less blood transfusion rate (OR: 2.05; 95% CI: 1.03 to 4.06; P = 0.04), shorter intestinal function recovery time (MD: 0.08; 95% CI: 0.52 to 1.09; P < 0.0001) and shorter hospitalization days (MD: 2.71; 95% CI: 1.03 to 4.39; P = 0.002). In addition, our results showed no statistically significant differences between the two groups in operation time (MD: 19.39; 95% CI: -6.67 to 45.44; P = 0.014), intraoperative blood loss (MD: 4.89; 95% CI: -105.00 to 114.79; P = 0.93) and total complication rate (RR: 1.22; 95% CI: 0.86 to 1.74; P = 0.27). In summary, our meta-analysis showed that ELRP is likely to be a safe and feasible alternative for localized PCa patients compared with TLRP.