Objective:To evaluate the efficiency,safety and clinical outcomes of Retziussparing robot-assisted radical prostatectomy(RS-RARP)in comparison with the standard RARP.Methods:A systematic search from Web of Science,Pub...Objective:To evaluate the efficiency,safety and clinical outcomes of Retziussparing robot-assisted radical prostatectomy(RS-RARP)in comparison with the standard RARP.Methods:A systematic search from Web of Science,PubMed,EMBase,Cochrane Library and Google Scholar was performed using the terms“Retzius-sparing”,“Bocciardi approach”and“robot-assisted radical prostatectomy”.Video articles and abstract papers for academic conferences were excluded.Meta-analysis of interested outcomes such as positive surgical margins(PSMs)and continence recovery was undertaken.A comprehensive literature review of all studies regarding Retzius-sparing(RS)approach was conducted and summarized.Results:From 2010 to 2017,11 original articles about RS-RARP approach were retrieved.Of that,only four studies comparing the RS-RARP approach to the conventional RARP were comparable for meta-analysis.Faster overall continence recovery within 1 month after the surgery was noted in the RS group(61%vs.43%;pZ0.004).PSMs of pT2 and pT3 stages were not significantly different between the groups(10.0%vs.7.4%;p Z 0.39 and 13.1%vs.9.5%,p Z 0.56,respectively).Of all the studies,only one reported sexual recovery outcomes after RS treatment in which 40%of the participants achieved sexual intercourse within the first month.Conclusion:Though more technically demanding than the conventional RARP,the RS technique is a safe and feasible approach.This meta-analysis and literature review indicates that RS technique,as opposed to the conventional approach,is associated with a faster continence recovery while PSMs were comparable between the two groups.The limitations of observational studies and the small data in our meta-analysis may prevent an ultimate conclusion.Future well-designed RCTs are needed to validate and confirm our findings.展开更多
文摘Objective:To evaluate the efficiency,safety and clinical outcomes of Retziussparing robot-assisted radical prostatectomy(RS-RARP)in comparison with the standard RARP.Methods:A systematic search from Web of Science,PubMed,EMBase,Cochrane Library and Google Scholar was performed using the terms“Retzius-sparing”,“Bocciardi approach”and“robot-assisted radical prostatectomy”.Video articles and abstract papers for academic conferences were excluded.Meta-analysis of interested outcomes such as positive surgical margins(PSMs)and continence recovery was undertaken.A comprehensive literature review of all studies regarding Retzius-sparing(RS)approach was conducted and summarized.Results:From 2010 to 2017,11 original articles about RS-RARP approach were retrieved.Of that,only four studies comparing the RS-RARP approach to the conventional RARP were comparable for meta-analysis.Faster overall continence recovery within 1 month after the surgery was noted in the RS group(61%vs.43%;pZ0.004).PSMs of pT2 and pT3 stages were not significantly different between the groups(10.0%vs.7.4%;p Z 0.39 and 13.1%vs.9.5%,p Z 0.56,respectively).Of all the studies,only one reported sexual recovery outcomes after RS treatment in which 40%of the participants achieved sexual intercourse within the first month.Conclusion:Though more technically demanding than the conventional RARP,the RS technique is a safe and feasible approach.This meta-analysis and literature review indicates that RS technique,as opposed to the conventional approach,is associated with a faster continence recovery while PSMs were comparable between the two groups.The limitations of observational studies and the small data in our meta-analysis may prevent an ultimate conclusion.Future well-designed RCTs are needed to validate and confirm our findings.
