首页良性前列腺增生治疗及预后证据详情

Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies

原文:2021年 发布于 Investig Clin Urol 62卷 第6期 631-640 浏览量:1682次 原文链接

作者: Scarcella S. Castellani D. Gauhar V. Teoh J. Y. Giulioni C. Piazza P. Bravi C. A. De Groote R. De Naeyer G. Puliatti S. Galosi A. B. Mottrie A.

作者单位: Urology Unit, Azienda Ospedaliero-Universitaria "Ospedali Riuniti di Ancona", Università Politecnica delle Marche, Ancona, Italy. Urology Unit, Azienda Ospedaliero-Universitaria "Ospedali Riuniti di Ancona", Università Politecnica delle Marche, Ancona, Italy. castellanidaniele@gmail.com. Department of Urology, Ng Teng Fong General Hospital, NUHS, Jurong East, Singapore. S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China. Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium. ORSI Academy, Melle, Belgium. Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.

归属分类: 良性前列腺增生治疗及预后证据

DOI: 10.4111/icu.20210297

关键词: Comparative Effectiveness Research Cost-Benefit Analysis Humans Male Operative Time *Postoperative Complications/etiology/therapy *Prostatectomy Prostatic Hyperplasia Recovery of Function *Robotic Surgical Procedures *Patient outcome assessment *Postoperative complications *Prostatectomy *Prostatic hyperplasia *Robotic surgical procedures

文献简介

PURPOSE: To review safety and efficacy of robotic-assisted simple prostatectomy (RASP) compared to open simple prostatectomy (OP). MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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