Critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis
Objectives: To systematically review studies comparing extraperitoneal (E-RP) and transperitoneal minimally invasive radical prostatectomy (T-RP). Methods: The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in S...
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Taylor & Francis Group
2017
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oai:doaj.org-article:dcaeacbdc0964013be913b0d23327b3b2021-12-02T13:03:32ZCritical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis2090-598X10.1016/j.aju.2017.07.003https://doaj.org/article/dcaeacbdc0964013be913b0d23327b3b2017-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2090598X17300955https://doaj.org/toc/2090-598XObjectives: To systematically review studies comparing extraperitoneal (E-RP) and transperitoneal minimally invasive radical prostatectomy (T-RP). Methods: The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in September 2015. Several databases were searched including Medline and Scopus. Only studies comparing E-RP and T-RP (either laparoscopic or robot-assisted approach) were evaluated. The follow-up of the included patients had to be â¥6 months. Results: In all, 1256 records were identified after the initial database search. Of these 20 studies (2580 patients) met the inclusion criteria. The hospital stay was significantly lower in the E-RP cohort, with a mean difference of â0.30 days (95% confidence interval [CI] â0.35, â0.24) for the laparoscopic group and 1.09 days (95% CI â1.47, â0.70) for the robotic group (P < 0.001). Early continence rates favoured the E-RP group, although this was statistically significant only in the laparoscopic group (odds ratio [OR] 2.52, 95% CI 1.72, 3.70; P < 0.001). There was no statistically significant difference between the E-RP and T-RP cohorts for 12-month continence rates for both the laparoscopic (OR 1.55, 95% CI 0.89, 2.69; P = 0.12) and robotic groups (OR 3.03, 95% CI 0.54, 16.85; P = 0.21). The overall complication and ileus rates were significantly lower in the E-RP cohort for both the laparoscopic and robotic groups. The symptomatic lymphocele rate favoured the T-RP cohort, although this was statistically significant only in the laparoscopic group (OR 8.69, 95% CI 1.60, 47.17; P = 0.01). Conclusion: This review suggests that the extraperitoneal approach is associated with a shorter hospital stay, lower overall complication rate, and earlier return to continence when compared to the transperitoneal approach. The transperitoneal approach has a lower lymphocele rate. Keywords: Extraperitoneal, Laparoscopy, Minimally invasive, Robotic, Transperitoneal, ProstatectomyPanagiotis KallidonisBhavan Prasad RaiHasan QaziRoman GanzerMinh DoAnja DietelEvangelos LiatsikosNabi GhulamIason KyriazisJens-Uwe StolzenburgTaylor & Francis GrouparticleDiseases of the genitourinary system. UrologyRC870-923ENArab Journal of Urology, Vol 15, Iss 4, Pp 267-279 (2017) |
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| topic |
Diseases of the genitourinary system. Urology RC870-923 |
| spellingShingle |
Diseases of the genitourinary system. Urology RC870-923 Panagiotis Kallidonis Bhavan Prasad Rai Hasan Qazi Roman Ganzer Minh Do Anja Dietel Evangelos Liatsikos Nabi Ghulam Iason Kyriazis Jens-Uwe Stolzenburg Critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis |
| description |
Objectives: To systematically review studies comparing extraperitoneal (E-RP) and transperitoneal minimally invasive radical prostatectomy (T-RP). Methods: The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in September 2015. Several databases were searched including Medline and Scopus. Only studies comparing E-RP and T-RP (either laparoscopic or robot-assisted approach) were evaluated. The follow-up of the included patients had to be â¥6 months. Results: In all, 1256 records were identified after the initial database search. Of these 20 studies (2580 patients) met the inclusion criteria. The hospital stay was significantly lower in the E-RP cohort, with a mean difference of â0.30 days (95% confidence interval [CI] â0.35, â0.24) for the laparoscopic group and 1.09 days (95% CI â1.47, â0.70) for the robotic group (P < 0.001). Early continence rates favoured the E-RP group, although this was statistically significant only in the laparoscopic group (odds ratio [OR] 2.52, 95% CI 1.72, 3.70; P < 0.001). There was no statistically significant difference between the E-RP and T-RP cohorts for 12-month continence rates for both the laparoscopic (OR 1.55, 95% CI 0.89, 2.69; P = 0.12) and robotic groups (OR 3.03, 95% CI 0.54, 16.85; P = 0.21). The overall complication and ileus rates were significantly lower in the E-RP cohort for both the laparoscopic and robotic groups. The symptomatic lymphocele rate favoured the T-RP cohort, although this was statistically significant only in the laparoscopic group (OR 8.69, 95% CI 1.60, 47.17; P = 0.01). Conclusion: This review suggests that the extraperitoneal approach is associated with a shorter hospital stay, lower overall complication rate, and earlier return to continence when compared to the transperitoneal approach. The transperitoneal approach has a lower lymphocele rate. Keywords: Extraperitoneal, Laparoscopy, Minimally invasive, Robotic, Transperitoneal, Prostatectomy |
| format |
article |
| author |
Panagiotis Kallidonis Bhavan Prasad Rai Hasan Qazi Roman Ganzer Minh Do Anja Dietel Evangelos Liatsikos Nabi Ghulam Iason Kyriazis Jens-Uwe Stolzenburg |
| author_facet |
Panagiotis Kallidonis Bhavan Prasad Rai Hasan Qazi Roman Ganzer Minh Do Anja Dietel Evangelos Liatsikos Nabi Ghulam Iason Kyriazis Jens-Uwe Stolzenburg |
| author_sort |
Panagiotis Kallidonis |
| title |
Critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis |
| title_short |
Critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis |
| title_full |
Critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis |
| title_fullStr |
Critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis |
| title_full_unstemmed |
Critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: A systematic review and meta-analysis |
| title_sort |
critical appraisal of literature comparing minimally invasive extraperitoneal and transperitoneal radical prostatectomy: a systematic review and meta-analysis |
| publisher |
Taylor & Francis Group |
| publishDate |
2017 |
| url |
https://doaj.org/article/dcaeacbdc0964013be913b0d23327b3b |
| work_keys_str_mv |
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