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Infectious Complications of Conventional Laparoscopic vs Robotic Laparoscopic Prostatectomy: A Systematic Literature

Alexandre R Marra1,2,3, Mireia Puig-Asensio1,2, Michael B Edmond1,2,4

  • 11 Office of Clinical Quality, Safety and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Journal of Endourology
|January 12, 2019
PubMed
Abstract

Insights

Robotic prostatectomy (RP) and laparoscopic prostatectomy (LP) have similar infectious complication rates. Earlier studies showed higher rates for RP, but this difference disappeared in later research, indicating comparable safety for both minimally invasive techniques.

Area of Science:

  • Urology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Minimally invasive prostatectomy (MIP) techniques, including conventional laparoscopy (LP) and robotic prostatectomy (RP), are associated with fewer perioperative complications than open surgery.
  • However, the comparative rates of infectious complications between RP and LP remain unclear.

Purpose of the Study:

  • To systematically review and meta-analyze infectious complications following robotic prostatectomy versus conventional laparoscopic prostatectomy.
  • To compare the incidence of infectious complications between RP and LP in patients undergoing prostatectomy.

Main Methods:

  • A systematic literature search was conducted across PubMed, CINAHL, CDSR, and EMBASE up to September 2018.
  • Random-effect models were used to calculate pooled odds ratios (pOR) for infectious complications, with heterogeneity assessed using I² and Cochran Q statistics.
  • Stratified analyses were performed based on the indication for prostatectomy and publication year.

Main Results:

  • Fifteen studies comprising 14,121 patients were included in the meta-analysis.
  • No statistically significant difference in infectious complications was found between RP and LP (pOR 0.94; 95% CI 0.50, 1.76).
  • Infectious complication rates were similar between RP and LP for prostate cancer patients (pOR 0.73; 95% CI 0.43, 1.24). While earlier studies (2007-2012) showed higher rates for RP, later studies (2013-2018) found no significant difference.

Conclusions:

  • Robotic prostatectomy and conventional laparoscopic prostatectomy are associated with comparable rates of infectious complications.
  • The observed trend of higher infectious complications with RP in earlier studies has diminished in more recent research, suggesting equivalent safety profiles for these minimally invasive approaches.
Keywords:
infectious complicationlaparoscopyminimally invasive techniqueprostatectomyrobotic

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