Endoscopic enucleation vs. robot-assisted simple prostatectomy for large prostates: a systematic review and meta-analysis of patients' perspectives.

IF 5.8 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2025-04-18 DOI:10.1038/s41391-025-00973-w

Andrea Alberti, Francesca Conte, Sara Costagli, Anna Cadenar, Rossella Nicoletti, Alessio Pecoraro, Arcangelo Sebastianelli, Jeremy Yuen Chun Teoh, Antonio Cicione, Riccardo Autorino, Henry H Woo, Ruben De Groote, Dean Elterman, Marcus Drake, Stavros Gravas, Vincenzo Ficarra, Cosimo De Nunzio, Sergio Serni, Riccardo Campi, Mauro Gacci

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引用次数: 0

Abstract

Introduction: Since Endoscopic Enucleation of the Prostate [EEP] and Robot-Assisted Simple Prostatectomy [RASP] showed comparable functional results, treatment selection is often based on clinicians' and patients' preferences. The aim of this systematic review was to compare Patient-Reported Outcomes Measures [PROMs] and Patient-Reported Experience Measures [PREMs] in patients with large prostate glands treated with EEP and RASP.

Evidence acquisition: Literature search was performed on August 29^th 2024 using the MEDLINE, EMBASE, and Cochrane CENTRAL databases, following the EAU Guidelines Office and the PRISMA statement recommendations. All comparative studies reporting validated PROMs/PREMs for both interventions (EEP and RASP) were included. Studies reporting within-treatment comparisons only (e.g., HoLEP vs. ThuLEP) were excluded.

Evidence synthesis: Ten studies involving 1105 patients (430 RASP, 675 EEP) were included in this systematic review. Follow-up ranged from 2 to 24 months. Considering urinary function, all authors reported a great improvement for both EEP and RASP at short- and mid-term, with no significant differences between endoscopic and robotic procedures. Alongside the lower symptom scores, patient-reported Quality of Life [QoL] significantly improved for both techniques. Erectile function remained stable after EEP and RASP in most of the studies, while some of them even reported a significant improvement. No studies reporting PREMs were retrieved.

Conclusions: Both RASP and EEP led to a great improvement in urinary function and QoL, safeguarding sexual function, with no significant difference between the different techniques in terms of functional outcomes. None of the included studies reported PREMs. A standardization of PROMs/PREMs and their integration in clinical practice is warranted, to understand the real impact of these treatments, helping physicians and patients for an individualized shared decision-making process.

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内镜下摘除与机器人辅助简单前列腺切除术治疗大前列腺：对患者观点的系统回顾和荟萃分析。

导读：由于内镜下前列腺摘除（EEP）和机器人辅助简单前列腺切除术（RASP）的功能效果相当，因此治疗选择通常基于临床医生和患者的偏好。本系统综述的目的是比较接受EEP和RASP治疗的大前列腺患者的患者报告结果测量（PROMs）和患者报告体验测量（PREMs）。证据获取：根据EAU指南办公室和PRISMA声明建议，于2024年8月29日使用MEDLINE、EMBASE和Cochrane CENTRAL数据库进行文献检索。所有报告两种干预措施（EEP和RASP）的验证prom /PREMs的比较研究均被纳入。仅报告治疗内比较的研究（例如，HoLEP与ThuLEP）被排除。证据综合：本系统综述纳入了10项研究，涉及1105例患者（430例RASP， 675例EEP）。随访时间为2 ~ 24个月。考虑到泌尿功能，所有作者都报道了短期和中期EEP和RASP的显著改善，内窥镜手术和机器人手术之间没有显著差异。除了较低的症状评分外，两种技术显著改善了患者报告的生活质量。在大多数研究中，EEP和RASP后勃起功能保持稳定，其中一些研究甚至报告了显着改善。没有报道PREMs的研究被检索到。结论：RASP和EEP均能显著改善患者的泌尿功能和生活质量，保护性功能，不同技术在功能结局方面无显著差异。纳入的研究均未报告PREMs。PROMs/PREMs的标准化及其在临床实践中的整合是必要的，以了解这些治疗的真正影响，帮助医生和患者进行个性化的共同决策过程。

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.