Tuan T. Nguyen , Muhammed A. Moukhtar Hammad , Ryan W. Dobbs , Huy G. Vuong , Jacob Basilius , Khoa Quy , Hanh T.T. Ngo , An Nguyen , Thi Tuyet Mai Tran , Narmina Khanmammadova , Trinh N.K. Van , Sohrab N. Ali , Ho Yee Tiong , Se Young Choi , Mohammed Shahait , David I. Lee
{"title":"门诊与住院机器人辅助根治性前列腺切除术的手术效果比较:系统回顾与元分析","authors":"Tuan T. Nguyen , Muhammed A. Moukhtar Hammad , Ryan W. Dobbs , Huy G. Vuong , Jacob Basilius , Khoa Quy , Hanh T.T. Ngo , An Nguyen , Thi Tuyet Mai Tran , Narmina Khanmammadova , Trinh N.K. Van , Sohrab N. Ali , Ho Yee Tiong , Se Young Choi , Mohammed Shahait , David I. Lee","doi":"10.1016/j.prnil.2024.04.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Several institutions have reported their experience with outpatient robot-assisted radical prostatectomy (O-RARP). However, it is unclear if the utilization of this approach represents an improvement over inpatient robot-assisted radical prostatectomy (I-RARP). This meta-analysis sought to compare the surgical outcomes between O-RARP and I-RARP.</div></div><div><h3>Methods</h3><div>For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until April 30, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR guidelines. The risk ratio (RR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>of the 297 retrieved abstracts, 12 underwent full-text review, and 11 studies were included in the final analysis, comprising a total cohort of 2,875 cases of robot-assisted radical prostatectomy (892 O-RARP cases and 1,983 I-RARP cases). Compared to I-RARP, the O-RARP group had lower mean operative time (MD = −9.4 minutes, 95% CI −15.1 to −3.7, <em>P</em> = 0.001), fewer overall postoperative complications (RR = 0.65, 95% CI 0.46 to 0.92, <em>P</em> = 0.017), shorter hospital stay (MD = −22.9 hours, 95% CI −26.0 to −19.7, <em>P</em> ≤ 0.001), and lower postoperative opioid requirements (RR = 0.45, 95% CI 0.28 to 0.71, <em>P</em> = 0.001). There were no significant differences in other outcomes, including: estimated blood loss, postoperative pain score, unscheduled visits after surgery, positive surgical margins, biochemical recurrence, International Prostate Symptom Score (IPSS) after surgery, or three- and six-month continence rates.</div></div><div><h3>Conclusions</h3><div>This meta-analysis demonstrates that O-RARP is a safe and feasible option for patients undergoing surgery for localized prostate cancer. Further studies are needed to better evaluate optimal patient selection, associated healthcare costs, and patient-reported outcomes.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 1-9"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A comparison of surgical outcomes between outpatient and inpatient robot-assisted radical prostatectomy: A systematic review and meta-analysis\",\"authors\":\"Tuan T. Nguyen , Muhammed A. Moukhtar Hammad , Ryan W. Dobbs , Huy G. Vuong , Jacob Basilius , Khoa Quy , Hanh T.T. Ngo , An Nguyen , Thi Tuyet Mai Tran , Narmina Khanmammadova , Trinh N.K. Van , Sohrab N. Ali , Ho Yee Tiong , Se Young Choi , Mohammed Shahait , David I. Lee\",\"doi\":\"10.1016/j.prnil.2024.04.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Several institutions have reported their experience with outpatient robot-assisted radical prostatectomy (O-RARP). However, it is unclear if the utilization of this approach represents an improvement over inpatient robot-assisted radical prostatectomy (I-RARP). This meta-analysis sought to compare the surgical outcomes between O-RARP and I-RARP.</div></div><div><h3>Methods</h3><div>For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until April 30, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR guidelines. The risk ratio (RR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>of the 297 retrieved abstracts, 12 underwent full-text review, and 11 studies were included in the final analysis, comprising a total cohort of 2,875 cases of robot-assisted radical prostatectomy (892 O-RARP cases and 1,983 I-RARP cases). Compared to I-RARP, the O-RARP group had lower mean operative time (MD = −9.4 minutes, 95% CI −15.1 to −3.7, <em>P</em> = 0.001), fewer overall postoperative complications (RR = 0.65, 95% CI 0.46 to 0.92, <em>P</em> = 0.017), shorter hospital stay (MD = −22.9 hours, 95% CI −26.0 to −19.7, <em>P</em> ≤ 0.001), and lower postoperative opioid requirements (RR = 0.45, 95% CI 0.28 to 0.71, <em>P</em> = 0.001). There were no significant differences in other outcomes, including: estimated blood loss, postoperative pain score, unscheduled visits after surgery, positive surgical margins, biochemical recurrence, International Prostate Symptom Score (IPSS) after surgery, or three- and six-month continence rates.</div></div><div><h3>Conclusions</h3><div>This meta-analysis demonstrates that O-RARP is a safe and feasible option for patients undergoing surgery for localized prostate cancer. Further studies are needed to better evaluate optimal patient selection, associated healthcare costs, and patient-reported outcomes.</div></div>\",\"PeriodicalId\":20845,\"journal\":{\"name\":\"Prostate International\",\"volume\":\"13 1\",\"pages\":\"Pages 1-9\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Prostate International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S228788822400028X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Prostate International","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S228788822400028X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
A comparison of surgical outcomes between outpatient and inpatient robot-assisted radical prostatectomy: A systematic review and meta-analysis
Introduction
Several institutions have reported their experience with outpatient robot-assisted radical prostatectomy (O-RARP). However, it is unclear if the utilization of this approach represents an improvement over inpatient robot-assisted radical prostatectomy (I-RARP). This meta-analysis sought to compare the surgical outcomes between O-RARP and I-RARP.
Methods
For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until April 30, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR guidelines. The risk ratio (RR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI).
Results
of the 297 retrieved abstracts, 12 underwent full-text review, and 11 studies were included in the final analysis, comprising a total cohort of 2,875 cases of robot-assisted radical prostatectomy (892 O-RARP cases and 1,983 I-RARP cases). Compared to I-RARP, the O-RARP group had lower mean operative time (MD = −9.4 minutes, 95% CI −15.1 to −3.7, P = 0.001), fewer overall postoperative complications (RR = 0.65, 95% CI 0.46 to 0.92, P = 0.017), shorter hospital stay (MD = −22.9 hours, 95% CI −26.0 to −19.7, P ≤ 0.001), and lower postoperative opioid requirements (RR = 0.45, 95% CI 0.28 to 0.71, P = 0.001). There were no significant differences in other outcomes, including: estimated blood loss, postoperative pain score, unscheduled visits after surgery, positive surgical margins, biochemical recurrence, International Prostate Symptom Score (IPSS) after surgery, or three- and six-month continence rates.
Conclusions
This meta-analysis demonstrates that O-RARP is a safe and feasible option for patients undergoing surgery for localized prostate cancer. Further studies are needed to better evaluate optimal patient selection, associated healthcare costs, and patient-reported outcomes.
期刊介绍:
Prostate International (Prostate Int, PI), the official English-language journal of Asian Pacific Prostate Society (APPS), is an international peer-reviewed academic journal dedicated to basic and clinical studies on prostate cancer, benign prostatic hyperplasia, prostatitis, and ...