Clinical Research Papers:
Robotic vs Retropubic radical prostatectomy in prostate cancer: A systematic review and a metaanalysis update
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Kun Tang1,*, Kehua Jiang1,2,*, Hongbo Chen2, Zhiqiang Chen1, Hua Xu1 and Zhangqun Ye1
1 Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
2 Department of Urology, The Central Hospital of Enshi Autonomous Prefecture, Enshi, China
* These authors have contributed equally to this work
Correspondence to:
Hua Xu, email:
Keywords: robotic-assisted radical prostatectomy; retropubic radical prostatectomy; prostate cancer; meta-analysis; update
Received: February 18, 2016 Accepted: October 21, 2016 Published: November 12, 2016
Abstract
CONTEXT: The safety and feasibility of robotic-assisted radical prostatectomy (RARP) compared with retropubic radical prostatectomy(RRP) is debated. Recently, a number of large-scale and high-quality studies have been conducted.
OBJECTIVE: To obtain a more valid assessment, we update the meta-analysis of RARP compared with RRP to assessed its safety and feasibility in treatment of prostate cancer.
METHODS: A systematic search of Medline, Embase, Pubmed, and the Cochrane Library was performed to identify studies that compared RARP with RRP. Outcomes of interest included perioperative, pathologic variables and complications.
RESULTS: 78 studies assessing RARP vs. RRP were included for meta-analysis. Although patients underwent RRP have shorter operative time than RARP (WMD: 39.85 minutes; P < 0.001), patients underwent RARP have less intraoperative blood loss (WMD = -507.67ml; P < 0.001), lower blood transfusion rates (OR = 0.13; P < 0.001), shorter time to remove catheter (WMD = -3.04day; P < 0.001), shorter hospital stay (WMD = -1.62day; P < 0.001), lower PSM rates (OR:0.88; P = 0.04), fewer positive lymph nodes (OR:0.45;P < 0.001), fewer overall complications (OR:0.43; P < 0.001), higher 3- and 12-mo potent recovery rate (OR:3.19;P = 0.02; OR:2.37; P = 0.005, respectively), and lower readmission rate (OR:0.70, P = 0.03). The biochemical recurrence free survival of RARP is better than RRP (OR:1.33, P = 0.04). All the other calculated results are similar between the two groups.
CONCLUSIONS: Our results indicate that RARP appears to be safe and effective to its counterpart RRP in selected patients.