单部位与多部位机器人辅助根治性前列腺切除术的早期结果：系统评价和荟萃分析。

Early outcomes of single-site versus multi-port robotic-assisted radical prostatectomy: A systematic review and meta-analysis.

机构信息

Chengdu Medical College, Chengdu, 610500, China; Department of Robotic Minimally Invasive Surgery Center, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.

Department of Operations Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.

出版信息

Eur J Surg Oncol. 2024 Jan;50(1):107263. doi: 10.1016/j.ejso.2023.107263. Epub 2023 Nov 10.

DOI:10.1016/j.ejso.2023.107263

PMID:37977045

Abstract

BACKGROUND

Single-site robotic-assisted radical prostatectomy (ssRARP) has been promoted in many institutions due to its minimally invasive approach. This review aimed to investigate early outcomes of ssRARP in comparison with multi-port robotic-assisted radical prostatectomy (mpRARP).

METHODS

A systematic literature search was performed for articles related to ssRARP case series and studies that compared ssRARP with mpRARP. The primary outcomes were functional and oncological outcomes, incision length, length of hospital stay and cost.

RESULTS

24 ssRARP case series involving 1385 cases, and 11 comparative studies involving 573 ssRARP cases and 980 mpRARP cases were included. Rate of immediate, 3-month, 6-month and 12-month recovery of continence in the ssRARP case series were 41 % [95 % CI: 0.38-0.45], 70 % [95 % CI: 0.67-0.73], 90 % [95 % CI: 0.87-0.93] and 93 % [95 % CI: 0.90-0.96]. 3-month potency recovery and positive surgical margin rate were 53 % [95 % CI: 0.46-0.60] and 21 % [95 % CI: 0.19-0.24]. No significant differences were detected between ssRARP and mpRARP in terms of 3-month (OR: 1.12; 95 % CI: 0.80-1.57) or 6-month (OR: 0.72; 95 % CI: 0.36-1.46) continence recovery rate, 3-month potency recovery rate (OR: 0.92; 95 % CI: 0.50-1.70), positive surgical margin rate (OR: 0.83; 95 % CI: 0.62-1.11), biochemical recurrence rate or total cost. Furthermore, ssRARP was associated with a significantly shorter length of incision and hospital stay.

CONCLUSION

ssRARP has significant advantages in cosmetic effect, length of incision and rapid recovery. Consequently, ssRARP is expected to become the preferred form although more evidence is needed to determine its long-term effect.

摘要

背景

由于微创的优势，单部位机器人辅助根治性前列腺切除术（ssRARP）已在许多机构中得到推广。本研究旨在比较 ssRARP 与多端口机器人辅助根治性前列腺切除术（mpRARP）的早期结果。

方法

对有关 ssRARP 病例系列和比较 ssRARP 与 mpRARP 的研究的文章进行系统文献检索。主要结局为功能和肿瘤学结局、切口长度、住院时间和成本。

结果

纳入 24 项 ssRARP 病例系列，涉及 1385 例，11 项比较研究，涉及 573 例 ssRARP 病例和 980 例 mpRARP 病例。ssRARP 病例系列中即时、3 个月、6 个月和 12 个月控尿恢复率分别为 41%[95%CI：0.38-0.45]、70%[95%CI：0.67-0.73]、90%[95%CI：0.87-0.93]和 93%[95%CI：0.90-0.96]。3 个月时勃起功能恢复率和阳性切缘率分别为 53%[95%CI：0.46-0.60]和 21%[95%CI：0.19-0.24]。ssRARP 与 mpRARP 在 3 个月（OR：1.12；95%CI：0.80-1.57）或 6 个月（OR：0.72；95%CI：0.36-1.46）控尿恢复率、3 个月勃起功能恢复率（OR：0.92；95%CI：0.50-1.70）、阳性切缘率（OR：0.83；95%CI：0.62-1.11）、生化复发率或总费用方面无显著差异。此外，ssRARP 还具有切口长度和住院时间更短的显著优势。