The Association of a Peritoneal Interposition Flap With Lymphocele Formation After Pelvic Lymph Node Dissection During Robotic-assisted Laparoscopic Radical Prostatectomy: A Systematic Review and Meta-analysis.

Autor: Estevez A; Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Bansal UK; Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Wagner JR; Division of Urologic Surgery, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT., Kaul S; Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA., Fleishman A; Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA., Bain PA; Countway Library, Harvard Medical School, Boston, MA., Chang P; Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Wagner AA; Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Gershman B; Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Electronic address: bgershma@bidmc.harvard.edu.
Jazyk: angličtina
Zdroj: Urology [Urology] 2024 Apr; Vol. 186, pp. 83-90. Date of Electronic Publication: 2024 Feb 16.
DOI: 10.1016/j.urology.2024.01.014
Abstrakt: Objective: To conduct a systematic review and meta-analysis to evaluate the association of a peritoneal interposition flap (PIF) with lymphocele formation following robotic-assisted laparoscopic radical prostatectomy (RALP) with pelvic lymph node dissection.
Methods: We conducted a systematic search of MEDLINE, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials through August 30, 2023, to identify randomized and nonrandomized studies comparing RALP with pelvic lymph node dissection with and without PIF. A random effects meta-analysis was then performed to evaluate the associations of PIF with 90-day postoperative outcomes.
Results: Five randomized controlled trials (RCTs) and four observational studies, including a total of 2941 patients, were included. The use of PIF was associated with a reduced risk of 90-day symptomatic lymphocele formation after RALP when examining only RCTs (pooled odds ratios [OR] 0.44, 95% CI 0.28-0.69; I 2 =3%) and both RCTs and observational studies (OR 0.35, 95% CI 0.22-0.56; I 2 =17%). Similarly, use of PIF was associated with a reduced risk of 90-day any lymphocele formation (OR 0.40, 95% CI 0.28-0.56, I 2 =39%). There were no statistically significant differences in postoperative complications between the two groups (OR 0.89; 95% CI 0.69-1.14; I 2 =20%).
Conclusion: Use of the PIF is associated with an approximately 50% reduced risk of symptomatic and any lymphocele formation within 90-days of surgery, and it is not associated with an increase in postoperative complications.
Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: