Comparison of surgical outcomes between outpatient and inpatient robot-assisted radical prostatectomy: a meta-analysis

You have accessJournal of UrologyCME1 Apr 2023PD27-08 COMPARISON OF SURGICAL OUTCOMES BETWEEN OUTPATIENT AND INPATIENT ROBOT-ASSISTED RADICAL PROSTATECTOMY: A META-ANALYSIS Muhammed A. Moukhtar Hammad, Tuan Nguyen, Ryan W. Dobbs, Huy Gia Vuong, Jacob Basilius, Khoa Quy, Hanh Thi Tuyet Ngo, An Nguyen, Thi Tuyet Mai Tran, Trinh Ngoc Khanh Van, Sohrab Naushad Ali, Ho Yee Tiong, Se Young Choi, Mohammed Shahait, and David I. Lee Muhammed A. Moukhtar HammadMuhammed A. Moukhtar Hammad More articles by this author , Tuan NguyenTuan Nguyen More articles by this author , Ryan W. DobbsRyan W. Dobbs More articles by this author , Huy Gia VuongHuy Gia Vuong More articles by this author , Jacob BasiliusJacob Basilius More articles by this author , Khoa QuyKhoa Quy More articles by this author , Hanh Thi Tuyet NgoHanh Thi Tuyet Ngo More articles by this author , An NguyenAn Nguyen More articles by this author , Thi Tuyet Mai TranThi Tuyet Mai Tran More articles by this author , Trinh Ngoc Khanh VanTrinh Ngoc Khanh Van More articles by this author , Sohrab Naushad AliSohrab Naushad Ali More articles by this author , Ho Yee TiongHo Yee Tiong More articles by this author , Se Young ChoiSe Young Choi More articles by this author , Mohammed ShahaitMohammed Shahait More articles by this author , and David I. LeeDavid I. Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003305.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Several institutions have reported their experience with outpatient robot-assisted radical prostatectomy (O-RARP). However, it is unclear if utilization of this approach represents an improvement over inpatient robot-assisted radical prostatectomy (I-RARP). This meta-analysis sought to compare the surgical outcomes between O-RARP and I-RARP. METHODS: For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until April 30, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. The risk ratio (RR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI). RESULTS: Of the 297 retrieved abstracts, 12 underwent full-text review, and 11 studies were included in the final analysis, comprising a total cohort of 2,875 cases of robot-assisted radical prostatectomy (892 O-RARP cases and 1,983 I-RARP cases). Compared to I-RARP, the O-RARP group had lower mean operative time (MD=-9.4 minutes, 95% CI -15.1 to -3.7, 0.001), fewer overall post-operative complications (RR=0.65, 95% CI 0.46 to 0.92, p=0.017), shorter hospital stay (MD=-22.9 hours, 95% CI -26.0 to -19.7, p≤0.001), and lower postoperative opioid requirements (RR=0.45, 95% CI 0.28 to 0.71, p=0.001). There were no significant differences in other outcomes, including: estimated blood loss, postoperative pain score, unscheduled visits after surgery, positive surgical margins, biochemical recurrence, International Prostate Symptom Score (IPSS) after surgery, or three- and six-month continence rates. (Table 1) CONCLUSIONS: This meta-analysis demonstrates that O-RARP is a safe and feasible option for patients undergoing surgery for localized prostate cancer. Further studies are needed to better evaluate optimal patient selection, associated healthcare costs, and patient reported outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e744 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Muhammed A. Moukhtar Hammad More articles by this author Tuan Nguyen More articles by this author Ryan W. Dobbs More articles by this author Huy Gia Vuong More articles by this author Jacob Basilius More articles by this author Khoa Quy More articles by this author Hanh Thi Tuyet Ngo More articles by this author An Nguyen More articles by this author Thi Tuyet Mai Tran More articles by this author Trinh Ngoc Khanh Van More articles by this author Sohrab Naushad Ali More articles by this author Ho Yee Tiong More articles by this author Se Young Choi More articles by this author Mohammed Shahait More articles by this author David I. Lee More articles by this author Expand All Advertisement PDF downloadLoading ...