Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies
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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Urological Association
2021-11-01
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| Series: | Investigative and Clinical Urology |
| Subjects: | |
| Online Access: | https://icurology.org/pdf/10.4111/icu.20210297 |
| _version_ | 1818834129655955456 |
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| author | Simone Scarcella Daniele Castellani Vineet Gauhar Jeremy Yuen-Chun Teoh Carlo Giulioni Pietro Piazza Carlo Andrea Bravi Ruben De Groote Geert De Naeyer Stefano Puliatti Andrea Benedetto Galosi Alexandre Mottrie |
| author_facet | Simone Scarcella Daniele Castellani Vineet Gauhar Jeremy Yuen-Chun Teoh Carlo Giulioni Pietro Piazza Carlo Andrea Bravi Ruben De Groote Geert De Naeyer Stefano Puliatti Andrea Benedetto Galosi Alexandre Mottrie |
| author_sort | Simone Scarcella |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T02:29:55Z |
| format | Article |
| id | doaj.art-af2addfa0e434d34afa74b2512d1d2a2 |
| institution | Directory Open Access Journal |
| issn | 2466-0493 2466-054X |
| language | English |
| last_indexed | 2024-12-19T02:29:55Z |
| publishDate | 2021-11-01 |
| publisher | Korean Urological Association |
| record_format | Article |
| series | Investigative and Clinical Urology |
| spelling | doaj.art-af2addfa0e434d34afa74b2512d1d2a22022-12-21T20:39:41ZengKorean Urological AssociationInvestigative and Clinical Urology2466-04932466-054X2021-11-0162663164010.4111/icu.20210297Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studiesSimone Scarcella 0https://orcid.org/0000-0003-3015-7271Daniele Castellani 1https://orcid.org/0000-0001-7354-9190Vineet Gauhar2https://orcid.org/0000-0002-3740-7141Jeremy Yuen-Chun Teoh 3https://orcid.org/0000-0002-9361-2342Carlo Giulioni4https://orcid.org/0000-0001-9934-4011Pietro Piazza5https://orcid.org/0000-0002-6740-534XCarlo Andrea Bravi 6https://orcid.org/0000-0002-6412-9546Ruben De Groote 7https://orcid.org/0000-0003-4081-8221Geert De Naeyer8https://orcid.org/0000-0003-4118-8807Stefano Puliatti9https://orcid.org/0000-0002-1597-9595Andrea Benedetto Galosi 10https://orcid.org/0000-0001-8313-5338Alexandre Mottrie11https://orcid.org/0000-0002-1253-1592Urology 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.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.Urology Unit, Azienda Ospedaliero-Universitaria “Ospedali Riuniti di Ancona”, Università Politecnica delle Marche, Ancona, Italy.Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.Urology Unit, Azienda Ospedaliero-Universitaria “Ospedali Riuniti di Ancona”, Università Politecnica delle Marche, Ancona, Italy.Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.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.https://icurology.org/pdf/10.4111/icu.20210297patient outcome assessmentpostoperative complicationsprostatectomyprostatic hyperplasiarobotic surgical procedures |
| spellingShingle | Simone Scarcella Daniele Castellani Vineet Gauhar Jeremy Yuen-Chun Teoh Carlo Giulioni Pietro Piazza Carlo Andrea Bravi Ruben De Groote Geert De Naeyer Stefano Puliatti Andrea Benedetto Galosi Alexandre Mottrie Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies Investigative and Clinical Urology patient outcome assessment postoperative complications prostatectomy prostatic hyperplasia robotic surgical procedures |
| title | Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies |
| title_full | Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies |
| title_fullStr | Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies |
| title_full_unstemmed | Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies |
| title_short | Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies |
| title_sort | robotic assisted versus open simple prostatectomy results from a systematic review and meta analysis of comparative studies |
| topic | patient outcome assessment postoperative complications prostatectomy prostatic hyperplasia robotic surgical procedures |
| url | https://icurology.org/pdf/10.4111/icu.20210297 |
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