Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis.
<h4>Background</h4>Robotic-assisted radical prostatectomy(RARP) is widely used to surgically treat of localized prostate cancer. Among RARP, retzius-sparing techniques(RS-RARP) are implemented through douglas pouch, not the existing conventional approach(C-RARP). We conducted an updated...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0268182 |
| _version_ | 1811290611368591360 |
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| author | Doo Yong Chung Hae Do Jung Do Kyung Kim Min Ho Lee Sin Woo Lee Sunghyun Paick Joo Yong Lee Seung Hyun Jeon |
| author_facet | Doo Yong Chung Hae Do Jung Do Kyung Kim Min Ho Lee Sin Woo Lee Sunghyun Paick Joo Yong Lee Seung Hyun Jeon |
| author_sort | Doo Yong Chung |
| collection | DOAJ |
| description | <h4>Background</h4>Robotic-assisted radical prostatectomy(RARP) is widely used to surgically treat of localized prostate cancer. Among RARP, retzius-sparing techniques(RS-RARP) are implemented through douglas pouch, not the existing conventional approach(C-RARP). We conducted an updated systematic review and meta-analysis including recent published papers.<h4>Materials & methods</h4>Systematic review was performed following the PRISMA guideline. PubMed, EMBASE, and Cochrane Library were searched up to August 2021. We conducted meta-analysis as follows; Participants, patients with biopsy-proven PCa; Interventions, Patients underwent C-RARP or RS-RALP; Outcomes, comparison of continence recovery rate, positive surgical margins(PSM), complication, operation time and estimated blood loss(EBL) included for analysis.<h4>Results</h4>Thirteen studies with a total of 2917 patients were included for meta-analysis. Among them, three were randomized controlled trials (RCT) studies and the rest were non-RCT studies. Incontinence was analyzed with zero pad and safety pad, respectively. There showed a statistically significant advantage for RS-RARP in terms of continence recovery at 1 month(0 pad; OR 0.28, (0.16-0.47), safety-pad; OR 0.12 (0.07-0.22), p<0.001), as well as at 3 months(0 pad; OR 0.31 (0.18-0.53), safety-pad; OR 0.23 (0.14-0.40) p<0.001), 6 months(0 pad; OR 0.29 (0.17-0.51), safety-pad; OR 0.13 (0.06-0.27), p<0.001). And after 12 months, RS-RARP showed better results only in the safety-pad(0 pad; OR 0.64 (0.35-1.18), p = 0.15, safety-pad; OR 0.12 (0.04-0.36), p<0.001). In PSM, there was no statistical difference between two group at overall stage, but RS-RARP was observed to be higher than C-RARP in pT3 subgroup analysis(OR 0.74 (0.55-0.99), p = 0.047) (Fig 1). Whereas, there was no significant difference between the two groups in complication, operation time, and EBL.<h4>Conclusions</h4>Our analysis showed that RS-RARP is superior about early continence recovery than C-RARP. However, RS-RARP showed relatively high PSM in locally advanced PCa of pT3 or above. Therefore, although RS-RARP has few advantages about functional outcomes, we think that caution should be exercised when approaching patients with high-risk local diseases. |
| first_indexed | 2024-04-13T04:15:43Z |
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| id | doaj.art-c13c544604a94a0b9b545fedd53c7548 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T04:15:43Z |
| publishDate | 2022-01-01 |
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| spelling | doaj.art-c13c544604a94a0b9b545fedd53c75482022-12-22T03:02:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01175e026818210.1371/journal.pone.0268182Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis.Doo Yong ChungHae Do JungDo Kyung KimMin Ho LeeSin Woo LeeSunghyun PaickJoo Yong LeeSeung Hyun Jeon<h4>Background</h4>Robotic-assisted radical prostatectomy(RARP) is widely used to surgically treat of localized prostate cancer. Among RARP, retzius-sparing techniques(RS-RARP) are implemented through douglas pouch, not the existing conventional approach(C-RARP). We conducted an updated systematic review and meta-analysis including recent published papers.<h4>Materials & methods</h4>Systematic review was performed following the PRISMA guideline. PubMed, EMBASE, and Cochrane Library were searched up to August 2021. We conducted meta-analysis as follows; Participants, patients with biopsy-proven PCa; Interventions, Patients underwent C-RARP or RS-RALP; Outcomes, comparison of continence recovery rate, positive surgical margins(PSM), complication, operation time and estimated blood loss(EBL) included for analysis.<h4>Results</h4>Thirteen studies with a total of 2917 patients were included for meta-analysis. Among them, three were randomized controlled trials (RCT) studies and the rest were non-RCT studies. Incontinence was analyzed with zero pad and safety pad, respectively. There showed a statistically significant advantage for RS-RARP in terms of continence recovery at 1 month(0 pad; OR 0.28, (0.16-0.47), safety-pad; OR 0.12 (0.07-0.22), p<0.001), as well as at 3 months(0 pad; OR 0.31 (0.18-0.53), safety-pad; OR 0.23 (0.14-0.40) p<0.001), 6 months(0 pad; OR 0.29 (0.17-0.51), safety-pad; OR 0.13 (0.06-0.27), p<0.001). And after 12 months, RS-RARP showed better results only in the safety-pad(0 pad; OR 0.64 (0.35-1.18), p = 0.15, safety-pad; OR 0.12 (0.04-0.36), p<0.001). In PSM, there was no statistical difference between two group at overall stage, but RS-RARP was observed to be higher than C-RARP in pT3 subgroup analysis(OR 0.74 (0.55-0.99), p = 0.047) (Fig 1). Whereas, there was no significant difference between the two groups in complication, operation time, and EBL.<h4>Conclusions</h4>Our analysis showed that RS-RARP is superior about early continence recovery than C-RARP. However, RS-RARP showed relatively high PSM in locally advanced PCa of pT3 or above. Therefore, although RS-RARP has few advantages about functional outcomes, we think that caution should be exercised when approaching patients with high-risk local diseases.https://doi.org/10.1371/journal.pone.0268182 |
| spellingShingle | Doo Yong Chung Hae Do Jung Do Kyung Kim Min Ho Lee Sin Woo Lee Sunghyun Paick Joo Yong Lee Seung Hyun Jeon Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis. PLoS ONE |
| title | Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis. |
| title_full | Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis. |
| title_fullStr | Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis. |
| title_full_unstemmed | Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis. |
| title_short | Outcomes of Retzius-sparing versus conventional robot-assisted radical prostatectomy: A KSER update series systematic review and meta-analysis. |
| title_sort | outcomes of retzius sparing versus conventional robot assisted radical prostatectomy a kser update series systematic review and meta analysis |
| url | https://doi.org/10.1371/journal.pone.0268182 |
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