Low Quality of Evidence for Robot-Assisted Laparoscopic Prostatectomy: Results of a Systematic Review of the Published Literature

Kang, Diana; Hardee, Miranda; Fesperman, Susan F.; Stoffs, Taryn; Dahm, Philipp

doi:10.1016/j.eururo.2010.01.034

Cited by 67 publications

(30 citation statements)

References 22 publications

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“…In addition, many urologists are unfamiliar with the quality grading and interpretation of the published literature[14]. Two contemporary reviews highlight the shortcomings in studies comparing ORP with RALP and question whether evidence-based medicine is driving RP practice patterns within the U.S.[15,16]. The intent of our review is to provide a critical analysis of ORP and RALP in terms of perioperative, oncologic, functional, and economic outcomes.…”

Section: Introductionmentioning

confidence: 99%

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lowrance

Tarin

Shariat

2010

The Scientific World JOURNAL

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The rapid adoption of robotic-assisted laparoscopic radical prostatectomy (RALP) has occurred despite a lack of high-quality evidence demonstrating its oncologic advantages, safety, or cost effectiveness compared with open radical retropubic prostatectomy (ORP). This review examines the current literature comparing ORP and RALP, focusing on perioperative, oncologic, functional, and economic outcomes.

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Section: Introductionmentioning

confidence: 99%

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lowrance

Tarin

Shariat

2010

The Scientific World JOURNAL

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“…10 Kang and colleagues published a review evaluating the quality of evidence comparing OP to RAP; they concluded that the robotic literature is limited to uncontrolled observational studies, many of which are methodologically poor. 11 Coelho and colleagues published a review of 58 studies showing similar overall complication rates with decreased operative blood loss and risk of transfusion with RAP. 12 The rate of positive surgical margins, incontinence and erectile dysfunction was also lower with RAP.…”

Section: Open Vs Robotic Prostatectomymentioning

confidence: 99%

Comparison of open and robotic-assisted prostatectomy: The University of British Columbia experience

Gagnon

Goldenberg

Lynch

et al. 2014

CUAJ

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Introduction:We assessed outcomes and costs of open prostatectomy (OP) versus robotic-assisted prostatectomy (RAP) at a single tertiary care university hospital. Results:The 2 groups had similar demographics, including mean age (64.7 vs. 64.2) and mean body mass index (27.2 vs. 27.2). The OP group had a higher proportion of higher risk cancers compared to the RAP group (32.5% vs. 8.5%). Mean skin-to-skin operative room time was less for the OP (114.2 vs. 234.1 minutes). Transfusion rates were similar at 1.5% with OP compared to 3.5% with RAP. The mean length of stay was 1.78 days for OP compared to 1.76 days for RAP, for the last 100 patients in each group. The OP group had more high-grade disease in the prostatectomy specimen, with Gleason ≥8 in 23.5% compared to 3.5% in the RAP group. Positive surgical margin rates were comparable at 31% for OP and 24.6% for RAP, and remained similar after stratification for pT2 and pT3 disease. The grade I and II perioperative complication rate (ClavienDindo classification) was lower in the OP group (8.5% vs. 20%). Postoperative stress urinary incontinence rates (4.8% for OP and 4.6% for RAP) and biochemical-free status (91.8% for OP and 96% for RAP) did not differ at 12 months post-surgery. The additional cost of RAP was calculated as $5629 per case. The main limitations of this study are its retrospective nature and lack of validated questionnaires for evaluation of postoperative functional outcomes. Conclusion: While hospital length of stay, transfusion rates, positive surgical margin rates and postoperative urinary incontinence were similar, OP had a shorter operative time and a lower cost compared to the very early experience of RAP. Future parallel prospective analysis will address the impact of the learning curve on these outcomes.

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“…Günümüzde ABD'de prostat kanseri tedavisinde uygulanan cerrahi prosedürlerin %60'ından fazlasını artık robotik cerrahi oluşturmaktadır (2). Uzun dönem sonuçlar kısıtlı olmak üzere erken dönem sonuçlar değerlendirildiğinde RRP'nin onkolojik, cinsel fonksiyon ve üriner sistem semptomları bakımından ARP ile kıyaslanabilecek sonuçlara sahip olduğu görülmektedir (3,4,5). ARP ve RRP arasında kıyaslama yapan çalışmalarda kan kaybı, hastanede kalış süresi gibi parametrelerde RRP'nin tartışmasız şekilde bir avantaj sağladığı belirtilmektedir.…”

Section: Introductionunclassified

Robotic Prostatectomy: Is it More Advantageous Regarding Quality of Life?

Yıldırım¹,

Çam²

2014

uob

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Low Quality of Evidence for Robot-Assisted Laparoscopic Prostatectomy: Results of a Systematic Review of the Published Literature

Cited by 67 publications

References 22 publications

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Comparison of open and robotic-assisted prostatectomy: The University of British Columbia experience

Robotic Prostatectomy: Is it More Advantageous Regarding Quality of Life?

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