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一项全面的检查和荟萃分析,评估了机器人辅助根治性前列腺切除术(RARP)与三维腹腔镜根治性前列腺切除术(3D LRP)相比的围手术期、肿瘤学和功能结果。

A comprehensive examination and meta-analysis evaluating perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) in comparison to three-dimensional laparoscopic radical prostatectomy (3D LRP).

机构信息

Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.

出版信息

J Robot Surg. 2024 Sep 30;18(1):356. doi: 10.1007/s11701-024-02110-6.

DOI:10.1007/s11701-024-02110-6
PMID:39347856
Abstract

Assessing the perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) versus three-dimensional laparoscopic radical prostatectomy (3D LRP), a comprehensive exploration of the Cochrane Library, PubMed, EMBASE, and Web of Science databases was carried out until July 2024. The combined results were evaluated by utilizing the weighted mean differences (WMDs) and odds ratios (ORs) through the application of Stata version 18, where data were gathered and scrutinized. In addition, sensitivity analyses were performed to ensure the robustness of our findings. In the meta-analysis we conducted, four studies were incorporated in total, which comprised two randomized controlled trials, one study that was retrospective and another that was prospective. The findings revealed that RARP was associated with a significantly reduced estimated blood loss (EBL) (WMD - 31.04, 95%CI - 54.57, - 7.51; p = 0.01) compared to 3D LRP. Nonetheless, there were no notable statistical variances seen between the two groups regarding operative time (OT), nerve-sparing rates, positive surgical margin (PSM) rates, biochemical recurrence (BCR) rates, or the restoration of urinary continence and potency 3 or 6 months after the surgery. In conclusion, our comprehensive meta-analysis has offered a detailed contrast between the results of RARP and 3D LRP in the treatment of prostate cancer. The findings highlight a considerable decrease in projected blood loss linked with RARP, yet no notable variances were detected between the two methods regarding other perioperative, oncological, and functional results.

摘要

对机器人辅助根治性前列腺切除术(RARP)与三维腹腔镜根治性前列腺切除术(3D LRP)的围手术期、肿瘤学和功能结果进行评估,全面检索了 Cochrane 图书馆、PubMed、EMBASE 和 Web of Science 数据库,检索截止日期为 2024 年 7 月。使用 Stata 版本 18 评估了应用加权均数差(WMD)和比值比(OR)合并结果,收集和审查了数据。此外,还进行了敏感性分析以确保我们研究结果的稳健性。在我们进行的荟萃分析中,共纳入了四项研究,其中两项为随机对照试验,一项为回顾性研究,另一项为前瞻性研究。结果表明,与 3D LRP 相比,RARP 与估计出血量(EBL)明显减少相关(WMD -31.04,95%CI -54.57,-7.51;p=0.01)。然而,两组之间手术时间(OT)、神经保留率、阳性切缘(PSM)率、生化复发(BCR)率以及术后 3 或 6 个月尿控和勃起功能恢复方面无显著统计学差异。总之,我们的综合荟萃分析详细对比了 RARP 和 3D LRP 在前列腺癌治疗中的结果。研究结果表明,RARP 与预计出血量减少显著相关,但两种方法在其他围手术期、肿瘤学和功能结果方面无显著差异。

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