{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T00:24:26Z","timestamp":1793579066497,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T00:00:00Z","timestamp":1510876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2018,6]]},"abstract":"\n Objective<\/jats:title>\n \n To determine the effects of laparoscopic radical prostatectomy (\n LRP<\/jats:styled-content>\n ), or robot\u2010assisted radical prostatectomy (\n RARP<\/jats:styled-content>\n ) compared with open radical prostatectomy (\n ORP<\/jats:styled-content>\n ) in men with localized prostate cancer.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n We performed a comprehensive search using multiple databases (\n CENTRAL<\/jats:styled-content>\n ,\n MEDLINE<\/jats:styled-content>\n ,\n EMBASE<\/jats:styled-content>\n ) and abstract proceedings, with no restrictions on the language of publication or publication status, up until 9 June 2017. We included all randomized or pseudo\u2010randomized controlled trials that directly compared\n LRP<\/jats:styled-content>\n and\n RARP<\/jats:styled-content>\n with\n ORP<\/jats:styled-content>\n . Two review authors independently examined full\u2010text reports, identified relevant studies, assessed the eligibility of studies for inclusion, extracted data and assessed risk of bias. We performed statistical analyses using a random\u2010effects model and assessed the quality of the evidence according to Grading of Recommendations Assessment, Development and Evaluation (\n GRADE<\/jats:styled-content>\n ). The primary outcomes were prostate cancer\u2010specific survival, urinary quality of life and sexual quality of life. Secondary outcomes were biochemical recurrence\u2010free survival, overall survival, overall surgical complications, serious postoperative surgical complications, postoperative pain, hospital stay and blood transfusions.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We included two unique studies in a total of 446 randomized participants with clinically localized prostate cancer. All available outcome data were short\u2010term (up to 3 months). We found no study that addressed the outcome of prostate cancer\u2010specific survival. Based on one trial,\n RARP<\/jats:styled-content>\n probably results in little to no difference in urinary quality of life (mean difference [\n MD<\/jats:styled-content>\n ] \u22121.30, 95% confidence interval [\n CI<\/jats:styled-content>\n ] \u22124.65 to 2.05; moderate quality of evidence) and sexual quality of life (\n MD<\/jats:styled-content>\n 3.90, 95%\n CI<\/jats:styled-content>\n : \u22121.84 to 9.64; moderate quality of evidence). No study addressed the outcomes of biochemical recurrence\u2010free survival or overall survival. Based on one trial,\n RARP<\/jats:styled-content>\n may result in little to no difference in overall surgical complications (risk ratio [\n RR<\/jats:styled-content>\n ] 0.41, 95%\n CI<\/jats:styled-content>\n : 0.16\u22121.04; low quality of evidence) or serious postoperative complications (\n RR<\/jats:styled-content>\n 0.16, 95%\n CI<\/jats:styled-content>\n : 0.02\u20131.32; low quality of evidence). Based on two studies,\n LRP<\/jats:styled-content>\n or\n RARP<\/jats:styled-content>\n may result in a small, possibly unimportant improvement in postoperative pain at 1 day (\n MD<\/jats:styled-content>\n \u22121.05, 95%\n CI<\/jats:styled-content>\n : \u22121.42 to \u22120.68; low quality of evidence) and up to 1 week (\n MD<\/jats:styled-content>\n \u22120.78, 95%\n CI<\/jats:styled-content>\n : \u22121.40 to \u22120.17; low quality of evidence). Based on one study,\n RARP<\/jats:styled-content>\n probably results in little to no difference in postoperative pain at 12 weeks (\n MD<\/jats:styled-content>\n 0.01, 95%\n CI<\/jats:styled-content>\n : \u22120.32 to 0.34; moderate quality of evidence). Based on one study,\n RARP<\/jats:styled-content>\n probably reduces the length of hospital stay (\n MD<\/jats:styled-content>\n \u22121.72, 95%\n CI<\/jats:styled-content>\n : \u22122.19 to \u22121.25; moderate quality of evidence). Based on two studies,\n LRP<\/jats:styled-content>\n or\n RARP<\/jats:styled-content>\n may reduce the frequency of blood transfusions (\n RR<\/jats:styled-content>\n 0.24, 95%\n CI<\/jats:styled-content>\n : 0.12\u20130.46; low quality of evidence). Assuming a baseline risk for a blood transfusion to be 8.9%,\n LRP<\/jats:styled-content>\n or\n RARP<\/jats:styled-content>\n would result in 68 fewer blood transfusions per 1,000 men (95%\n CI<\/jats:styled-content>\n : 78\u201348 fewer).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n There is no evidence to inform the comparative effectiveness of\n LRP<\/jats:styled-content>\n or\n RARP<\/jats:styled-content>\n compared with\n ORP<\/jats:styled-content>\n for oncological outcomes. Urinary and sexual quality of life appear similar. Overall and serious postoperative complication rates appear similar. The difference in postoperative pain may be minimal. Men undergoing\n LRP<\/jats:styled-content>\n or\n RARP<\/jats:styled-content>\n may have a shorter hospital stay and receive fewer blood transfusions.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.14062","type":"journal-article","created":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T01:36:36Z","timestamp":1508808996000},"page":"845-853","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":105,"title":["Laparoscopic and robot\u2010assisted vs open radical prostatectomy for the treatment of localized prostate cancer: a Cochrane systematic review"],"prefix":"10.1111","volume":"121","author":[{"given":"Dragan","family":"Ilic","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine School of Public Health and Preventive Medicine Monash University Melbourne Vic. 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hung","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Urology Yonsei University Wonju College of Medicine Wonju Korea"},{"name":"Department of Urology University of Minnesota Minneapolis MN USA"},{"name":"Urology Section Minneapolis VA Health Care System Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7500-5899","authenticated-orcid":false,"given":"Declan","family":"Murphy","sequence":"additional","affiliation":[{"name":"Cancer Surgery Peter MacCallum Cancer Centre Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Frydenberg","sequence":"additional","affiliation":[{"name":"Department of Surgery Monash University Melbourne Vic. 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