Extraperitoneal versus transperitoneal approach for robot-assisted radical prostatectomy: a contemporary systematic review and meta-analysis

被引:0
作者
Michael Uy
Raees Cassim
Jaehoon Kim
Jen Hoogenes
Bobby Shayegan
Edward D. Matsumoto
机构
[1] McMaster University,Division of Urology, Department of Surgery
[2] McMaster University,Michael G. DeGroote School of Medicine
[3] St. Joseph’s Healthcare Hamilton,Department of Urology, McMaster Institute of Urology
来源
Journal of Robotic Surgery | 2022年 / 16卷
关键词
Robot-assisted; Radical prostatectomy; Extraperitoneal; Transperitoneal; Systematic review;
D O I
暂无
中图分类号
学科分类号
摘要
We aim to evaluate the differences in peri-operative characteristics, surgical complications, and oncological and functional control between the extraperitoneal RARP (EP-RARP) and transperitoneal RARP (TP-RARP). A comprehensive database search was performed up to March 2021 for eligible studies comparing outcomes between EP-RARP versus TP-RARP. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO. A leave-one-out sensitivity analysis was performed to control for heterogeneity and risk of bias. A total of 16 studies were included with 3897 patients, including 2201 (56.5%) EP-RARPs and 1696 (43.5%) TP-RARPs. When compared to TP-RARP, EP-RARP offers faster operative time (MD − 14.4 min; 95% CI − 26.3, − 2.3), decreased length of post-operative stay (MD − 0.9 days, 95% CI − 1.3, − 0.4), and decreased rates of post-operative ileus (RR 0.2, 95% CI 0.1, 0.7) and inguinal hernia formation (RR 0.2, 95% CI 0.1, 0.5). There were no significant differences in total complications, estimated blood loss, positive surgical margins, or continence at 6 months. In this review, EP-RARP delivered similar oncological and functional outcomes, while also offering faster operative time, decreased length of post-operative stay, and decreased rates of post-operative ileus and inguinal hernia formation when compared to TP-RARP. These findings provide evidence-based data for surgical approach optimization and prompts future research to examine whether these findings hold true with recent advances in single-port RARP and outpatient RARP.
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页码:257 / 264
页数:7
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