Comparison of retropubic radical prostatectomy and standard laparoscopic radical prostatectomy: a meta-analysis / 中华泌尿外科杂志

ABSTRACT

Objective To compare the outcomes of standard laparoscopic radical prostatectomy (SLRP) and retropubic radical prostatectomy (RRP) via meta-analysis.Methods A systematic literature search of articles from January 1992 to April 2015 was conducted via Pubmed,Web of Science,Cochrane Library,and EMBASE databases,and the references of the retrieved articles.Fixed-or random-effect models were used to summarize the estimates to evaluate operation time,blood loss,transfusion,catheterization time,hospital stay,surgical margin status,perioperative complications,postoperative erectile dysfunction,and postoperative urinary incontinence in these two approaches.Results A total of 17 articles were included in this study.Compared with RRP group,the operation time was longer in SLRP group (SMD =1.20,95％ CI 0.83,1.58).On the contrary,the SLRP group held advantages in blood loss (SMD =-2.02,95％ CI -2.67,-1.37),transfusion (RR =0.22,95％ CI 0.16,0.30),catheterization time (SMD =-1.44,95 ％ CI-2.34,-0.54),hospital stay (SMD =-0.97,95 ％ CI-1.29,-0.66) (P ＜ 0.05).Moreover,these two approaches showed no difference in surgical margin status (RR =0.94,95 ％ CI 0.84,1.05),perioperative complications (RR =0.78,95％ CI 0.60,1.02),postoperative erectile dysfunction (RR =1.13,95 ％ CI 0.97,1.31),and postoperative urinary incontinence (RR =0.85,95 ％ CI 0.57,1.28) (P ＞0.05).Conclusions Compared with RRP,SLRP could be a more suitable approach to treat localized prostate cancer.Random clinical trials are needed in the future to better evaluate these two approaches.