Abstract:

Objective · To assess the outcomes of robotic-assisted laparoscopic prostatectomy (RALP)and laparoscopic radical prostatectomy (LRP). Methods · Databases including PubMed, Web of Science, Cochrane Library, EMbase, EBSCO, CINAHL, CNKI , WangFang and VIP Database were searched to collect the controlled studies on RALP for localized prostate cancer. Meta-analysis was applied using the Review Manager V5.3 software in accordance with the Cochrane Collaboration. Results · A total of 15 studies were identified, including 1 621 cases of RALP and 1 894 cases of LRP. The results of meta-analysis showed that, compared to LRP, operative blood loss[WMD=-120.29, 95% CI (-182.20, -58.39), P=0.0001] and transfusion rate[OR=0.44, 95% CI (0.25, 0.79), P=0.006] were lower in RALP. Moreover, RALP was associated with significantly improved outcomes in the postoperative urinary continence rate of 3-month, 6-month, 12- month[OR=2.76, 95% CI (1.99, 3.82), P<0.000 01; OR=2.50, 95% CI (1.72, 3.63), P<0.000 01; OR=2.28, 95% CI (1.51, 3.46), P<0.000 1]. But there were no significant differences between the two techniques in operation time, rate of positive surgical margins and complication (P>0.05). Conclusion · RALP showed benefits in terms of operative blood loss, transfusion rate as well as functional outcomes. Further studies of larger populations with a longer follow-up are needed to make any statement.

Key words: robotic-assisted, laparoscopic, prostatectomy, meta-analysis