Comparación entre la prostatectomía con preservación del espacio de Retzius y la prostatectomía radical estándar asistida por robot para el cáncer de próstata

Tahra, Ahmet; Şen, Uğur; Sobay, Resul; İnkaya, Abdurrahman; Küçük, Eyüp Veli; Boylu, Uğur

doi:10.1016/j.acuro.2021.01.011

Cited by 3 publications

(11 citation statements)

References 17 publications

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“…Moreover, outcomes at 1, 3, 6, and 12 months were also evaluated. As shown in the forest plot, RS‐RARP had better 1 and 3 months incontinence recovery rates; (OR = 4.57; 95% CI = [1.32–15.77]; Figure 5) 10,13–15 and (OR = 2.93; 95% CI = [1.57–5.46]; Figure 6), 10,12,13,16,17 respectively. Conversely, at 6 and 12 months, the incontinence recovery rate was not statistically significant between groups; (OR = 3.28; 95% CI = [0.52–20.83]; Figure 7) 10,12,16 and (OR = 3.07; 95% CI = [0.86–10.94]; Figure 8).…”

Section: Resultsmentioning

confidence: 90%

“…Conversely, at 6 and 12 months, the incontinence recovery rate was not statistically significant between groups; (OR = 3.28; 95% CI = [0.52–20.83]; Figure 7) 10,12,16 and (OR = 3.07; 95% CI = [0.86–10.94]; Figure 8). 9,12,14,16,17 …”

Section: Resultsmentioning

confidence: 99%

“…A total of 17 studies were included in the PSM analysis, involving 2875 patients 9–25 . PSM rates for RS‐RARP and c‐RARP are summarized in the table (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Figure 16). 9,14,[18][19][20]22,23,25 Of the studies included, six reported data about biochemical recurrence (BCR) after a 1-year follow-up. 9,12,16,19,20,24 All of them defined BCR as PSA value ≥ 0.2 ng/mL in two consecutive measures.…”

Section: Oncologic Outcomesmentioning

confidence: 99%

“…The meta-analysis reported no statistically significant intergroup difference (SMD = -0.14; 95% CI = [−0.41 to 0.12]; Figure 20). [9][10][11][12]14,15,[17][18][19][20][21][22]24 3.6 | Length of stay (LOS)…”

Section: Operation Timementioning

confidence: 99%

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Surgical and functional outcomes of Retzius‐sparing robotic‐assisted radical prostatectomy versus conventional robotic‐assisted radical prostatectomy in patients with biopsy‐confirmed prostate cancer. Are outcomes worth it? Systematic review and meta‐analysis

O'Connor‐Cordova,

Macías,

Sancen‐Herrera

et al. 2023

The Prostate

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BackgroundRadical prostatectomy is the standard of care for prostate cancer. Retzius‐sparing robotic‐assisted radical prostatectomy (RS‐RARP) is being widely adopted due to positive functional outcomes compared to conventional robotic‐assisted radical prostatectomy (c‐RARP). Concerns regarding potency, oncological outcomes, and learning curve are still a matter of debate.MethodsFollowing Preferred Instrument for Systematic Reviews and Meta‐Analysis guidelines and PROSPERO registration CRD42023398724, a systematic review was performed in February 2023 on RS‐RARP compared to conventional c‐RARP. Outcomes of interest were continence recovery, potency, positive surgical margins (PSM), biochemical recurrence (BCR), estimated blood loss (EBL), length of stay (LOS), operation time and complications. Data were analyzed using R version 4.2.2.ResultsA total of 17 studies were included, totaling 2751 patients, out of which 1221 underwent RS‐RARP and 1530 underwent c‐RARP. Continence was analyzed using two definitions: zero pad and one safety pad. Cumulative analysis showed with both definitions statistical difference in terms of continence recovery at 1 month (0 pad odds ratio [OR] = 4.57; 95% confidence interval [CI] = [1.32–15.77]; Safety pad OR = 13.19; 95% CI = [8.92–19.49]), as well as at 3 months (0 pad OR, 2.93; 95% CI = [1.57–5.46]; Safety pad OR = 5.31; 95% CI = [1.33–21.13]). Continence recovery at 12 months was higher in the one safety pad group after RS‐RARP (OR = 4.37; 95% CI = [1.97–9.73]). The meta‐analysis revealed that overall PSM rates without pathologic stage classification were not different following RS‐RARP (OR = 1.13; 95% CI = [0.96–1.33]. Analysis according to the tumor stage revealed PSM rates in pT2 and pT3 tumors are not different following RS‐RARP compared to c‐RARP (OR = 1.46; 95% CI = [0.84–2.55]) and (OR = 1.41; 95% CI = [0.93–2.13]), respectively. No difference in potency at 12 months (OR = 0.98; 95% CI = [0.69–1.41], BCR at 12 months (OR = 0.99; 95% CI = [0.46–2.16]), EBL (standardized mean difference [SMD] = −0.01; 95% CI = [−0.31 to 0.29]), LOS (SMD = −0.01; 95% CI = [−0.48 to 0.45]), operation time (SMD = ‐0.14; 95% CI = [−0.41 to 0.12]) or complications (OR = 0.9; 95% CI = [0.62–1.29]) were observed.ConclusionsOur analysis suggests that RS‐RARP is safe and feasible. Faster continence recovery rate is seen after RS‐RARP. Potency outcomes appear to be similar. PSM rates are not different following RS‐RARP regardless of pathologic stage. Further quality studies are needed to confirm these findings.

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Section: Resultsmentioning

confidence: 90%

Section: Resultsmentioning

confidence: 99%

“…A total of 17 studies were included in the PSM analysis, involving 2875 patients 9–25 . PSM rates for RS‐RARP and c‐RARP are summarized in the table (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Section: Oncologic Outcomesmentioning

confidence: 99%

Section: Operation Timementioning

confidence: 99%

See 3 more Smart Citations

Surgical and functional outcomes of Retzius‐sparing robotic‐assisted radical prostatectomy versus conventional robotic‐assisted radical prostatectomy in patients with biopsy‐confirmed prostate cancer. Are outcomes worth it? Systematic review and meta‐analysis

O'Connor‐Cordova,

Macías,

Sancen‐Herrera

et al. 2023

The Prostate

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Retzius-sparing vs. standard robot-assisted radical prostatectomy for clinically localised prostate cancer: a comparative study

Ficarra

Rossanese

Gilante

et al. 2022

Prostate Cancer Prostatic Dis

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The spread of retzius-sparing robotic prostatectomy: an update after 10 years

Galfano

Secco

Olivero

et al. 2023

Current Opinion in Urology

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Purpose of reviewObjective of our work is to provide an update of the state of the art concerning Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) and to give a possible vision on the future developments of this new approach.Recent findingsA nonsystematic literature review has been conducted, finding 27 comparative studies and 24 reviews published up to April 15, 2023. Most of these studies confirm the advantages of RS-RARP relative to standard RARP mainly on early continence recovery. Conversely, discordant findings are reported for the benefit of RS-RARP on late continence recovery. Uncertainty is still present on the impact on positive surgical margins (PSMs), but this statement is based on low level of evidence. Several data concerning the learning curve have shown the safety of RS-RARP, but the need of adequate tutoring. Recent studies also confirmed the feasibility of RS-RARP in the setting of high-risk prostate cancer (PCa), large prostate volume, patients with an history of benign prostatic hyperplasia surgery and patients with a transplanted kidney. Atypical advantages can be also seen in the reduction of risk of postoperative inguinal hernias and in case of concomitant rectal resection.SummaryRetzius-sparing RARP has been confirmed to be one of the standard approaches for the treatment of PCa, with well documented advantages and uncertainty on PSMs.

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Comparación entre la prostatectomía con preservación del espacio de Retzius y la prostatectomía radical estándar asistida por robot para el cáncer de próstata

Cited by 3 publications

References 17 publications

Surgical and functional outcomes of Retzius‐sparing robotic‐assisted radical prostatectomy versus conventional robotic‐assisted radical prostatectomy in patients with biopsy‐confirmed prostate cancer. Are outcomes worth it? Systematic review and meta‐analysis

Surgical and functional outcomes of Retzius‐sparing robotic‐assisted radical prostatectomy versus conventional robotic‐assisted radical prostatectomy in patients with biopsy‐confirmed prostate cancer. Are outcomes worth it? Systematic review and meta‐analysis

Retzius-sparing vs. standard robot-assisted radical prostatectomy for clinically localised prostate cancer: a comparative study

The spread of retzius-sparing robotic prostatectomy: an update after 10 years

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