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Journal of Robotic Surgery
Published in: Journal of Robotic Surgery 4/2018

01-12-2018 | Original Article

Prostatectomies for localized prostate cancer: a mixed comparison network and cumulative meta-analysis

Authors: Kannan Sridharan, Gowri Sivaramakrishnan

Published in: Journal of Robotic Surgery | Issue 4/2018

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Abstract

No consensus has been attained regarding the utility of open retropubic radical prostatectomy (RRP), laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALRP) for localized prostate cancer (PCa). We carried out a network meta-analysis and cumulative meta-analysis comparing RRP, LRP and RALRP on peri-operative and functional outcome measures. Electronic databases were searched for either randomized clinical trials or cohort studies comparing RALRP either with LRP or RRP in patients with localized PCa. Outcome measures were as follows: overall, pT2 and pT3-positive surgical margins (PSMs); biochemical recurrence (BCR); complication rates; estimated blood loss; blood transfusion rate; continence and potency rates; duration of catheterization and hospital stay. Publication bias, risk of bias and inconsistency were assessed. Inverse heterogeneity model was used for analysis. A total of 45 studies were included for the final analysis. We observed that RALRP and LRP did not differ significantly from RRP with regard to the following outcomes: overall PSM; pT2 and pT3 PSMs; OT; complication rate; continence and potency rates; total blood loss and hospital stay. Duration of catheterization was significantly shorter in RALRP than LRP and RRP while significant reductions in the need for blood transfusion and BCR were observed for both RALRP and LRP in comparison with RRP. To conclude, similar functional, operative and oncologic outcomes were observed for both RALRP and LRP compared to RRP.
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Metadata
Title
Prostatectomies for localized prostate cancer: a mixed comparison network and cumulative meta-analysis
Authors
Kannan Sridharan
Gowri Sivaramakrishnan
Publication date
01-12-2018
Publisher
Springer London
Published in
Journal of Robotic Surgery / Issue 4/2018
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI
https://doi.org/10.1007/s11701-018-0791-8

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