Robotic-Assisted vs. Open Simple Prostatectomy for Large Prostates: A Meta-Analysis.

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Benign prostatic hyperplasia (BPH) is a common condition in aging men.
• Large prostates (>80g) present surgical challenges.
• Traditional open simple prostatectomy (OSP) is effective but associated with significant morbidity.

Approach:

• Systematic review and meta-analysis of controlled trials comparing Robotic-assisted Simple Prostatectomy (RASP) and Open Simple Prostatectomy (OSP).
• Searched Cochrane Library, PubMed, Embase, and Science databases up to December 2020.
• Included seven studies with 3,777 patients.

Key Points:

• No significant differences in International Prostate Symptom Score (IPSS), Quality of Life (QoL), maximum flow rate (Qmax), or post-void residual (PVR) volume.
• RASP demonstrated significantly shorter length of stay (LOS), less estimated blood loss (EBL), shorter console time (CT), and fewer overall complications compared to OSP.
• RASP was associated with a longer operative time (OT).

Conclusions:

• Robotic-assisted simple prostatectomy (RASP) is as effective as open simple prostatectomy (OSP) for treating large benign prostatic hyperplasia.
• RASP offers improved safety outcomes, including reduced complications and shorter hospital stays.
• RASP is a feasible and effective alternative surgical option for large BPH.