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Robot-assisted radical prostatectomy has lower biochemical recurrence than laparoscopic radical prostatectomy: Systematic review and meta-analysis

Authors
 Seon Heui Lee,1 Hyun Ju Seo,2 Na Rae Lee,3 Soo Kyung Son,3 Dae Keun Kim,4,5 and Koon Ho Rhacorresponding author6 
Citation
 INVESTIGATIVE AND CLINICAL UROLOGY, Vol.58(3) : 152-163, 2017 
Journal Title
 INVESTIGATIVE AND CLINICAL UROLOGY 
ISSN
 2466-0493 
Issue Date
2017
MeSH
Humans ; Laparoscopy*/methods ; Male ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/surgery* ; Prostate/surgery ; Prostatectomy/adverse effects ; Prostatectomy/methods* ; Prostatic Neoplasms/surgery* ; Robotic Surgical Procedures*/methods ; Urinary Incontinence/etiology
Keywords
Laparoscopy ; Meta-analysis ; Prostatectomy ; Prostatic neoplasms ; Robotics
Abstract
PURPOSE: To assess the effectiveness and safety of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer. MATERIALS AND METHODS: Existing systematic reviews were updated to investigate the effectiveness and safety of RARP. Electronic databases, including Ovid MEDLINE, Ovid Embase, the Cochrane Library, KoreaMed, Kmbase, and others, were searched through July 2014. The quality of the selected systematic reviews was assessed by using the revised assessment of multiple systematic reviews (R-Amstar) and the Cochrane Risk of Bias tool. Meta-analysis was performed by using Revman 5.2 (Cochrane Community) and Comprehensive Meta-Analysis 2.0 (CMA; Biostat). Cochrane Q and I2 statistics were used to assess heterogeneity. RESULTS: Two systematic reviews and 16 additional studies were selected from a search performed of existing systematic reviews. These included 2 randomized controlled clinical trials and 28 nonrandomized comparative studies. The risk of complications, such as injury to organs by the Clavien-Dindo classification, was lower with RARP than with LRP (relative risk [RR], 0.44; 95% confidence interval [CI], 1.23-0.85; p=0.01). The risk of urinary incontinence was lower (RR, 0.43; 95% CI, 0.31-0.60; p<0.000001) and the potency rate was significantly higher with RARP than with LRP (RR, 1.38; 95% CI, 1.11-1.70; I2=78%; p=0.003). Regarding positive surgical margins, no significant difference in risk between the 2 groups was observed; however, the biochemical recurrence rate was lower after RARP than after LRP (RR, 0.59; 95% CI, 0.48-0.73; I2=21%; p<0.00001). CONCLUSIONS: RARP appears to be a safe and effective technique compared with LRP with a lower complication rate, better potency, a higher continence rate, and a decreased rate of biochemical recurrence.
Files in This Item:
T201702356.pdf Download
DOI
10.4111/icu.2017.58.3.152
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160427
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