Safety and effectiveness of robot-assisted radical prostatectomy by retzius sparing approach: a systematic review and meta-analysis
作者单位：Department of Urology Tongde HospitalZhejiang Province
会议名称：《首届男性大健康中西医协同创新论坛暨第三届全国中西医结合男科青年学术论坛》
会议日期：2019年
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
摘 要：Objectives The aim of this article is to compare the perioperative safety,oncological outcomes and early urinary continence rate(UCR) between RS-RARP and conventional RARP(C-RARP). Methods A systematic search of the literature was performed in May 2017 using the Embase,Cochrane Library and Pub Med database. The terms-retzius sparing,bocciardi approach, trans-Douglas robotic radical prostatectomy and posterior robot radical prostatectomy, were searched with the following limits: humans, gender(male), and language(English). Only comparative studies and case series ≥ 20 cases regarding the perioperative safety,oncological outcomes and early UCR were included. A meta-analysis was conducted with the data from the selected studies. Results A total of 11 articles were included into our review: 2 randomized controlled trials(RCT), 4 non-randomized controlled studies and 5 case series. The oncological outcomes were shown not significantly different between RS-RARP and C-RARP. The weighted mean UCR at 1 week, 1, 2 and 3 months after catheter removal were 55.3%, 84.8%, 89.4%, 97.0% vs33.4%, 57.6%, 67.4%, 80.9% in RS-RARP and C-RARP groups respectively in the six comparative studies. The overall analysis of comparative studies presented that RS-RARP statistically improved early continence recovery rate at 1 week, 1, 2 and 3 months after catheter ***, RS-RARP technique tended to spend less time radically resecting the prostate(Console time,) than C-RARP, with no significant differences of perioperative complication rate and estimated blood loss between the two RARP techniques. Conclusion According to the data from the short-term follow-up, RS-RARP has safe oncology, low complication rate and earlier urinary continence recovery. However,more long-term RCT are still needed to be further conducted.