| Objectives:To compare the efficacy and safety between Retzius-sparing robot-assisted laparoscopic radical prostatectomy(RSRARP)with conventional robot-assisted laparoscopic radical prostatectomy(CRARP).Method:A research was conducted in Medline via PubMed、Web of science、Cochrane library、Embase、CKNI、Wanfang、Weipu 、CBM and other database from the establish ment of the database to May 31,2021.We collect literatures comparing RSRARP and CRARP,including randomized controlled trials(RCT),prospective and retrospective studies.According to exclude and include standards,the reviewer extracted all relevant data from the screened documents and then analyzed the extracted date by using Rev Man5.3 software.The indicators observed in this study include the operating time,estimated blood loss,Length of postoperative hospital stay,overall complication rate,positive surgical margin,erectile dysfunction recovery rate,postoperative urinary control recovery rate and biological recurrence-free survival rate.Result:Thirteen studies were eventually included,including four RCTs,four prospective studies,and five retrospective studies.A total of 1848 cases were included in the study,including 951 cases in the RSRARP group and 897 cases in the CRARP group.Metaanalysis showed there was no significant difference in operating time(WMD=1.53,95%CI:-11.82～14.87,P=0.82),estimated blood loss(WMD=8.97,95%CI:-5.85～23.80,P=0.24),overall complication rate(OR=1.03,95%CI:0.68～1.55,P=0.89)and biological recurrence-free survival rate(OR=1.12,95%CI:0.43～1.2.94,P=0.82).There were statistically significant in Length of postoperative hospital stay(WMD=-0.69,95%CI:-0.86～-0.52,P<0.00001),positive surgical margin(OR=1.39,95%CI:1.07～1.80,P=0.01),immediate recovery of urinary continence after surgery(OR=1.39,95%CI:1.07～1.80,P<0.00001),recovery of urinary continence 1 month after surgery(OR=3.83,95%CI:1.78～8.28,P=0.0006),recovery of urinary continence 3 months after surgery(OR=4.84,95%CI:3.24～7.22,P<0.00001),recovery of urinary continence 12 months after surgery(OR=2.49,95%CI:1.36～4.57,P=0.003)and erectile dysfunction recovery rate(OR=1.74,95%CI:1.03～2.94,P=0.004).Conclusions:Both RSRARP and CRARP can benefit patients with prostate cancer,but RSRARP is superior to CRARP in terms of length of stay,erectile dysfunction recovery rate and urinary control recovery rate.Considering that there are few studies in this meta-analysis,it need large samples of prospective randomized controlled trials are needed to prove the conclusions. |
