Chong-Jian Wang, Cheng-Cheng Pang, Jiao Qin, Cai-Xia Chen, Hao-Tian Huang, Hong-Yuan Li, Song Cao, Xue-Song Yang
{"title":"对机器人辅助根治性前列腺切除术(RARP)与三维腹腔镜根治性前列腺切除术(3D LRP)的围手术期、肿瘤学和功能结果进行全面检查和荟萃分析评估。","authors":"Chong-Jian Wang, Cheng-Cheng Pang, Jiao Qin, Cai-Xia Chen, Hao-Tian Huang, Hong-Yuan Li, Song Cao, Xue-Song Yang","doi":"10.1007/s11701-024-02110-6","DOIUrl":null,"url":null,"abstract":"<p><p>Assessing the perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) versus three-dimensional laparoscopic radical prostatectomy (3D LRP), a comprehensive exploration of the Cochrane Library, PubMed, EMBASE, and Web of Science databases was carried out until July 2024. The combined results were evaluated by utilizing the weighted mean differences (WMDs) and odds ratios (ORs) through the application of Stata version 18, where data were gathered and scrutinized. In addition, sensitivity analyses were performed to ensure the robustness of our findings. In the meta-analysis we conducted, four studies were incorporated in total, which comprised two randomized controlled trials, one study that was retrospective and another that was prospective. The findings revealed that RARP was associated with a significantly reduced estimated blood loss (EBL) (WMD - 31.04, 95%CI - 54.57, - 7.51; p = 0.01) compared to 3D LRP. Nonetheless, there were no notable statistical variances seen between the two groups regarding operative time (OT), nerve-sparing rates, positive surgical margin (PSM) rates, biochemical recurrence (BCR) rates, or the restoration of urinary continence and potency 3 or 6 months after the surgery. In conclusion, our comprehensive meta-analysis has offered a detailed contrast between the results of RARP and 3D LRP in the treatment of prostate cancer. The findings highlight a considerable decrease in projected blood loss linked with RARP, yet no notable variances were detected between the two methods regarding other perioperative, oncological, and functional results.</p>","PeriodicalId":47616,"journal":{"name":"Journal of Robotic Surgery","volume":"18 1","pages":"356"},"PeriodicalIF":2.2000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A comprehensive examination and meta-analysis evaluating perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) in comparison to three-dimensional laparoscopic radical prostatectomy (3D LRP).\",\"authors\":\"Chong-Jian Wang, Cheng-Cheng Pang, Jiao Qin, Cai-Xia Chen, Hao-Tian Huang, Hong-Yuan Li, Song Cao, Xue-Song Yang\",\"doi\":\"10.1007/s11701-024-02110-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Assessing the perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) versus three-dimensional laparoscopic radical prostatectomy (3D LRP), a comprehensive exploration of the Cochrane Library, PubMed, EMBASE, and Web of Science databases was carried out until July 2024. The combined results were evaluated by utilizing the weighted mean differences (WMDs) and odds ratios (ORs) through the application of Stata version 18, where data were gathered and scrutinized. In addition, sensitivity analyses were performed to ensure the robustness of our findings. In the meta-analysis we conducted, four studies were incorporated in total, which comprised two randomized controlled trials, one study that was retrospective and another that was prospective. The findings revealed that RARP was associated with a significantly reduced estimated blood loss (EBL) (WMD - 31.04, 95%CI - 54.57, - 7.51; p = 0.01) compared to 3D LRP. Nonetheless, there were no notable statistical variances seen between the two groups regarding operative time (OT), nerve-sparing rates, positive surgical margin (PSM) rates, biochemical recurrence (BCR) rates, or the restoration of urinary continence and potency 3 or 6 months after the surgery. In conclusion, our comprehensive meta-analysis has offered a detailed contrast between the results of RARP and 3D LRP in the treatment of prostate cancer. The findings highlight a considerable decrease in projected blood loss linked with RARP, yet no notable variances were detected between the two methods regarding other perioperative, oncological, and functional results.</p>\",\"PeriodicalId\":47616,\"journal\":{\"name\":\"Journal of Robotic Surgery\",\"volume\":\"18 1\",\"pages\":\"356\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Robotic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11701-024-02110-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Robotic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11701-024-02110-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
为了评估机器人辅助前列腺癌根治术(RARP)与三维腹腔镜前列腺癌根治术(3D LRP)的围术期、肿瘤学和功能性结果,我们对 Cochrane Library、PubMed、EMBASE 和 Web of Science 数据库进行了全面探索,直至 2024 年 7 月。通过使用 Stata 18 版收集和仔细研究数据,利用加权平均差(WMDs)和几率比(ORs)对综合结果进行了评估。此外,我们还进行了敏感性分析,以确保研究结果的稳健性。在我们进行的荟萃分析中,共纳入了四项研究,其中包括两项随机对照试验、一项回顾性研究和另一项前瞻性研究。研究结果显示,与三维 LRP 相比,RARP 可显著降低估计失血量(EBL)(WMD - 31.04, 95%CI - 54.57, - 7.51; p = 0.01)。不过,在手术时间(OT)、神经保留率、手术切缘阳性率(PSM)、生化复发率(BCR)或术后 3 个月或 6 个月的排尿持续性和排尿能力的恢复方面,两组之间没有明显的统计学差异。总之,我们的综合荟萃分析详细对比了 RARP 和 3D LRP 治疗前列腺癌的结果。研究结果表明,RARP 可显著减少预计失血量,但两种方法在其他围手术期、肿瘤学和功能结果方面没有发现明显差异。
A comprehensive examination and meta-analysis evaluating perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) in comparison to three-dimensional laparoscopic radical prostatectomy (3D LRP).
Assessing the perioperative, oncological, and functional results of robotic-assisted radical prostatectomy (RARP) versus three-dimensional laparoscopic radical prostatectomy (3D LRP), a comprehensive exploration of the Cochrane Library, PubMed, EMBASE, and Web of Science databases was carried out until July 2024. The combined results were evaluated by utilizing the weighted mean differences (WMDs) and odds ratios (ORs) through the application of Stata version 18, where data were gathered and scrutinized. In addition, sensitivity analyses were performed to ensure the robustness of our findings. In the meta-analysis we conducted, four studies were incorporated in total, which comprised two randomized controlled trials, one study that was retrospective and another that was prospective. The findings revealed that RARP was associated with a significantly reduced estimated blood loss (EBL) (WMD - 31.04, 95%CI - 54.57, - 7.51; p = 0.01) compared to 3D LRP. Nonetheless, there were no notable statistical variances seen between the two groups regarding operative time (OT), nerve-sparing rates, positive surgical margin (PSM) rates, biochemical recurrence (BCR) rates, or the restoration of urinary continence and potency 3 or 6 months after the surgery. In conclusion, our comprehensive meta-analysis has offered a detailed contrast between the results of RARP and 3D LRP in the treatment of prostate cancer. The findings highlight a considerable decrease in projected blood loss linked with RARP, yet no notable variances were detected between the two methods regarding other perioperative, oncological, and functional results.
期刊介绍:
The aim of the Journal of Robotic Surgery is to become the leading worldwide journal for publication of articles related to robotic surgery, encompassing surgical simulation and integrated imaging techniques. The journal provides a centralized, focused resource for physicians wishing to publish their experience or those wishing to avail themselves of the most up-to-date findings.The journal reports on advance in a wide range of surgical specialties including adult and pediatric urology, general surgery, cardiac surgery, gynecology, ENT, orthopedics and neurosurgery.The use of robotics in surgery is broad-based and will undoubtedly expand over the next decade as new technical innovations and techniques increase the applicability of its use. The journal intends to capture this trend as it develops.