Several institutions have reported their experience with outpatient robot-assisted radical prostatectomy (O-RARP). However, it is unclear if the utilization of this approach represents an improvement over inpatient robot-assisted radical prostatectomy (I-RARP).
This meta-analysis sought to compare the surgical outcomes between O-RARP and I-RARP.
For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until April 30, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR guidelines. The risk ratio (RR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI).
of the 297 retrieved abstracts, 12 underwent full-text review, and 11 studies were included in the final analysis, comprising a total cohort of 2,875 cases of robot-assisted radical prostatectomy (892 O-RARP cases and 1,983 I-RARP cases). Compared to I-RARP, the O-RARP group had lower mean operative time (MD = -9.4 minutes, 95% CI -15.1 to -3.7, P = 0.001), fewer overall postoperative complications (RR = 0.65, 95% CI 0.46 to 0.92, P = 0.017), shorter hospital stay (MD = -22.9 hours, 95% CI -26.0 to -19.7, P ≤ 0.001), and lower postoperative opioid requirements (RR = 0.45, 95% CI 0.28 to 0.71, P = 0.001). There were no significant differences in other outcomes, including: estimated blood loss, postoperative pain score, unscheduled visits after surgery, positive surgical margins, biochemical recurrence, International Prostate Symptom Score (IPSS) after surgery, or three- and six-month continence rates.
This meta-analysis demonstrates that O-RARP is a safe and feasible option for patients undergoing surgery for localized prostate cancer. Further studies are needed to better evaluate optimal patient selection, associated healthcare costs, and patient-reported outcomes.
Prostate international. 2024 Apr 24 [Epub]
Tuan T Nguyen, Muhammed A Moukhtar Hammad, Ryan W Dobbs, Huy G Vuong, Jacob Basilius, Khoa Quy, Hanh T T Ngo, An Nguyen, Thi Tuyet Mai Tran, Narmina Khanmammadova, Trinh N K Van, Sohrab N Ali, Ho Yee Tiong, Se Young Choi, Mohammed Shahait, David I Lee
Department of Urology, University of California Irvine, Orange, USA., Cook County Health & Hospitals System, Chicago, USA., Oklahoma University Health Sciences Center, Oklahoma City, USA., University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam., National University Hospital, Singapore, Singapore., Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea., Surgery Department, Clemenceau Medical Center Dubai, Dubai, United Arab Emirates.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/40213347