RS-RARP better than C-RARP in terms of postoperative continence recovery: Study

China: Results from a recent meta-analysis revealed Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) to be better than conventional RARP (C-RARP) in terms of postoperative continence recovery. However, the study showed no significant differences in sexual function recovery rates, intraoperative blood loss, operation time, length of stay, positive margin rate, and complications. The study was published in the journal Prostate Cancer and Prostatic Diseases on 25 October 2021.

Robotic prostatectomy is a minimally invasive procedure performed by an experienced laparoscopic surgery team with the assistance of advanced surgical technology.  It is considered the 'gold standard' treatment for patients with organ-confined prostate cancer and greater than 10 years life expectancy. RARP is carried out using the da Vinci Surgical System, a sophisticated robotic surgery system that allows surgeons to operate on the prostate with enhanced vision, control and precision. Retzius-sparing robot-assisted laparoscopic radical prostatectomy (rsRARP) allows entire prostatectomy procedure via the pouch of Douglas. 

Delin Wang, Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China, and colleagues aimed to compare C-RARP and RS-RARP and to find out which is better between the two operation methods.

The researchers presented the meta-analysis on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The meta-analysis was carried out using Review Manager 5.3 (Cochrane Collaboration, Oxford, United Kingdom) and Stata SE 14.0. 

The meta-analysis revealed that RS-RARP had a statistically significant advantage in terms of continence recovery immediately after operation (OR: 0.40), after 1 month (OR: 0.17), after 3 months (OR: 0.18), after 6 months (OR: 0.26) and after 12 months (OR: 0.50).

"This meta-analysis found that RS-RARP had better postoperative continence recovery than C-RARP, while sexual function recovery rates were not significantly different," the authors wrote. "There were also no significant differences in operation time, intraoperative blood loss, length of stay, positive margin rate and complications."

Reference:

Liu, J., Zhang, J., Yang, Z. et al. Comparison of Retzius-sparing and conventional robot-assisted laparoscopic radical prostatectomy regarding continence and sexual function: an updated meta-analysis. Prostate Cancer Prostatic Dis (2021). https://doi.org/10.1038/s41391-021-00459-5