| Abstract [eng] |
The objective of the study is to provide a systematic analysis of the advantages of robotic-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) versus open radical prostatectomy (ORP). An independent systematic review of the literature was performed up to April 2023, using the PubMed database. Search strategies, selection criteria, and evidence reports were created in accordance with the recommendations of the Preferred Reporting Items for Systematic Review (PRISMA). Surgical, pathological, and functional outcomes, were reviewed. In the 14 studies, a total of 29472 patients were included in the review, 15067 (51%), 1713 (6%), and 12692 (43%) were RARP, LRP, and ORP, respectively. Across all studies, the RARP approach demonstrated significant advantages in the majority of outcomes. Robotic-assisted radical prostatectomy demonstrated advantages in surgical outcomes, including significantly lower estimated blood loss and reduced hospital stay compared to LRP and ORP. Functional outcomes favoured RARP, with higher rates of urinary continence and erectile function reported. Additionally, RARP showed favourable oncological outcomes, such as lower positive surgical margin rates and reduced risk of biochemical recurrence compared to other approaches. Recent evidence and technological advancements, such as fluorescence-guided surgery and 3D printing indicate, that RARP is an advantageous surgical option for the treatment of localized prostate cancer and is likely to continue to increase in popularity worldwide in the coming years. However, there is a need for further evaluation of long-term outcomes, and the higher cost associated with robotic surgery remains a notable concern in the context of prostate cancer treatment. |
