Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies.
Patient outcome assessment
Postoperative complications
Prostatectomy
Prostatic hyperplasia
Robotic surgical procedures
Journal
Investigative and clinical urology
ISSN: 2466-054X
Titre abrégé: Investig Clin Urol
Pays: Korea (South)
ID NLM: 101674989
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
28
07
2021
revised:
14
08
2021
accepted:
12
09
2021
entrez:
3
11
2021
pubmed:
4
11
2021
medline:
19
2
2022
Statut:
ppublish
Résumé
To review safety and efficacy of robotic-assisted simple prostatectomy (RASP) compared to open simple prostatectomy (OP). A comprehensive literature search was performed to assess the differences in perioperative course and functional outcomes in patients with benign prostatic hyperplasia and surgical indication. The incidences of complications were pooled using the Cochran-Mantel-Haenszel Method and expressed as odds ratio (OR), 95% confidence interval (CI), and p-values. Perioperative course and functional outcomes were pooled using the inverse variance of the mean difference (MD), 95% CI, and p-values. Analyses were two-tailed and the significance was set at p<0.05. Eight studies were accepted. Meta-analysis showed significantly longer surgical time (MD, 43.72; 95% CI, 30.57-56.88; p<0.00001) with a significantly lower estimated blood loss (MD, -563.20; 95% CI, -739.95 to -386.46; p<0.00001) and shorter postoperative stay (MD, -2.85; 95% CI, -3.72 to -1.99; p<0.00001) in RASP. Catheterization time did not differ (MD, 0.65; 95% CI, -2.17 to 3.48; p=0.65). The risk of blood transfusion was significantly higher in OP (OR, 0.23; 95% CI, 0.17-0.33; p<0.00001). The risk of recatheterization (OR, 1.96; 95% CI, 0.32-11.93; p=0.47), postoperative urinary infections (OR, 0.89; 95% CI, 0.23-3.51; p=0.87) and 30-day readmission rate (OR, 0.96; 95% CI, 0.61-1.51; p=0.86) did not differ. At 3-month follow-up, functional outcomes were similar. RASP demonstrated a better perioperative outcome and equal early functional outcomes as compared to OP. These findings should be balanced against the longer operative time and higher cost of robotic surgery.
Identifiants
pubmed: 34729963
pii: 62.631
doi: 10.4111/icu.20210297
pmc: PMC8566792
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
631-640Informations de copyright
© The Korean Urological Association, 2021.
Déclaration de conflit d'intérêts
The authors have nothing to disclose.
Références
J Endourol. 2018 Sep 12;32(9):865-870
pubmed: 30062904
J Robot Surg. 2021 Aug;15(4):627-633
pubmed: 33009988
J Clin Epidemiol. 2020 Feb;118:42-54
pubmed: 31698064
Can Urol Assoc J. 2015 Sep-Oct;9(9-10):E626-30
pubmed: 26425225
Curr Urol Rep. 2016 Jun;17(6):44
pubmed: 27048160
J Robot Surg. 2022 Apr;16(2):295-300
pubmed: 33837950
Prostate Int. 2021 Jun;9(2):101-106
pubmed: 34386453
BMJ. 2016 Oct 12;355:i4919
pubmed: 27733354
J Robot Surg. 2020 Aug;14(4):601-607
pubmed: 31560124
Eur Urol. 2015 Jul;68(1):86-94
pubmed: 25484140
PLoS One. 2014 Jul 08;9(7):e101615
pubmed: 25003963
J Endourol. 2017 Nov;31(11):1164-1169
pubmed: 28854815
Arab J Urol. 2016 Mar;14(1):50-8
pubmed: 26966594
World J Urol. 2019 Sep;37(9):1927-1931
pubmed: 30515596
World J Urol. 2016 Sep;34(9):1207-19
pubmed: 26699627
Urol Clin North Am. 2016 Aug;43(3):385-91
pubmed: 27476131
BJU Int. 2021 Aug;128(2):168-177
pubmed: 32981194
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Urology. 2020 Jul;141:173-177
pubmed: 32171697
BJU Int. 2019 Feb;123(2):313-317
pubmed: 30198196
Int J Technol Assess Health Care. 2012 Apr;28(2):138-44
pubmed: 22559755
Urology. 2020 Feb;136:19-34
pubmed: 31726185
World J Urol. 2021 Jan;39(1):149-156
pubmed: 32222811
J Clin Med. 2020 Jun 09;9(6):
pubmed: 32527020
J Urol. 2008 Feb;179(2):513-5
pubmed: 18076926
Transl Androl Urol. 2021 May;10(5):2151-2157
pubmed: 34159097