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Perioperative, functional, and oncologic outcomes in patients undergoing robot-assisted radical prostatectomy previous transurethral resection of prostate: a systematic review and meta-analysis of comparative trials

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Abstract

The influence of robot-assisted radical prostatectomy (RARP) on patients who have previously undergone transurethral resection of the prostate (TURP) versus TURP-naive patients is still debatable. The present study aimed to compare perioperative, functional, and oncologic outcomes of RARP between TURP and Non-TURP groups. We systematically searched the databases such as Science, PubMed, Embase, Web of Science, and the Cochrane Library database to identify relevant studies published in English up to August 2022. Review Manager was used to compare various parameters. The study was registered with PROSPERO (CRD42022378126). Eight comparative trials with a total of 4186 participants were conducted. The TURP group had a longer operative time (WMD 22.22 min, 95% CI 8.48, 35.95; p = 0.002), a longer catheterization time (WMD 1.32 day, 95% CI 0.37, 2.26; p = 0.006), a higher estimated blood loss (WMD 23.86 mL, 95% CI 2.81, 44.90; p = 0.03), and higher bladder neck reconstruction rate (OR 8.02, 95% CI 3.07, 20.93; p < 0.0001). Moreover, the positive surgical margin (PSM) was higher in the TURP group (OR 1.49, 95% CI 1.12, 1.98 p = 0.007). However, there was no difference between the two groups regarding the length of hospital stay, transfusion rates, nerve-sparing status, complication rates, long-term continence, potency rates and biochemical recurrence (BCR). Performing RARP on patients who have previously undergone TURP is a safe procedure. Furthermore, the current findings demonstrated that the TURP group had comparable oncologic and long-term functional outcomes to the Non-TURP group.

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The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Yang Liu, Jiao Qin and Kun-peng Li have equally contributed to this work.

Authors and Affiliations

  1. Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China

    Yang Liu, Zhi Wen, Jing Huang, Yu Jiang, Cai-xia Chen, Chong-jian Wang, Li Wang, Jia-hao Wang & Xue-song Yang

  2. Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China

    Jiao Qin

  3. Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China

    Kun-peng Li

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  1. Yang Liu
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by LY, LK, QJ and YX. The first draft of the manuscript was written by LY and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xue-song Yang.

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Liu, Y., Qin, J., Li, Kp. et al. Perioperative, functional, and oncologic outcomes in patients undergoing robot-assisted radical prostatectomy previous transurethral resection of prostate: a systematic review and meta-analysis of comparative trials. J Robotic Surg 17, 1271–1285 (2023). https://doi.org/10.1007/s11701-023-01555-5

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