| Objective: To discuss the effect of pelvic floor reconstruction in Robot assisted laparoscopic radical prostatectomy on urinary continence.Method: Databases including PubMed,Web of Science,Embase,Cochrane library,CNKI and Wan Fang data were systematically searched for clinical studies about pelvic floor reconstruction in Robot assisted laparoscopic radical prostatectomy on urinary continence published since database builded.Two researchers independently completed literature screening and data extraction according to the inclusion criteria and exclusion criteria.Data qualities were evaluated by JADAD scale and Newcastle-Ottawa Scale(NOS)and meta-analysis was performed by RevMan 5.3 software provided by Cochrane Collaboration.Result: A total of 13 studies(2 randomized controlled trials and 11 retrospective cohort studies)with the use of robot assisted laparoscopic radical prostatectomy were included in this meta-analysis.The patients underwent pelvic floor reconstruction were assigned to the Pelvic floor reconstruction(PR)group,while the patients without pelvic floor reconstruction were assigned to the non Pelvic floor reconstruction(nPR)group.There were 2629 patients in the PR group and 1238 patients in the nPR group.Meta-analysis showed that there were no significant differences in age,BMI,prostate volume,preoperative PSA and Glesson score between two groups(P> 0.05).Two groups had no significant differences in surgery time(MD=-0.38,95%CI:-3.49~2.74,P=0.81),estimated blood loss(MD=6.84,95%CI:-32.39~46.08,P=0.73),postoperativecatheterization time(MD=-0.11,95%CI:-0.35~0.12,P=0.35),complicatios(RD=-0.03,95%CI:-0.07~0.01,P=0.19)and surgical margin positive rate(OR=1.25,95%CI:0.94~1.68,P=0.13).About the recovery of urinary continence,the differences of 1 week after surgery(OR=2.61,95%CI:1.28~5.33,P=0.008),2 weeks after surgery(OR=3.05,95%CI:1.89~4.92,P<0.0001),4 weeks after surgery(OR=1.65,95%CI:1.27~2.13,P=0.0002),12 weeks after surgery(OR=2.80,95%CI:1.22~6.41,P=0.02),24 weeks after surgery(OR=3.05,95%CI:1.28~7.27,P=0.01)and 52 weeks after surgery(OR=5.07,95%CI:1.22~21.03,P=0.03)had statistical significance(P< 0.05).Conclusion: Pelvic floor reconstruction in Robot assisted laparoscopic radical prostatectomy has advantages in urinary continence recovery at 1,2,4,12,24 and 52 weeks after operation,while it does not increase the difficulties and complications of operation. |
