OBJECTIVE: To compare operative outcomes of robot-assisted radical prostatectomy (RARP) in obese and nonobese patients with prostate cancer. MATERIALS AND METHODS: A literature search of MEDLINE, EMBASE, Google Scholar, and the Cochrane Library was performed up to March 2014. All studies that have assessed operative outcomes of RARP in obese and nonobese patients were included. Outcome measures were perioperative and functional results, including operating time, estimated blood loss (EBL), complications, length of hospital stay (LOS), positive surgical margins (PSMs), and recovery of continence and potency. Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect model. Subgroup analysis was performed for institutions with greater experience of RARP in obese cases. RESULTS: Thirteen observational studies from 12 study population were included for 1821 obese patients compared with 4801 nonobese patients. Operating time (p=0.0001; WMD: 24.28; 95% CI, 11.93-36.64) and EBL (p=0.003; WMD: 38.28; 95% CI, 13.45-63.11) were significantly increased in obese patients compared with nonobese counterparts. There was no significant difference in complications, LOS, or PSM rates. Subgroup analysis for studies that have involved ≥100 obese cases showed consistent results, but the increases in operating time (9.8 minutes; 95% CI, 1.7-18 minutes) and EBL (14 mL; 95% CI, 5.0-23 mL) were much lower compared with the original analysis. As for functional outcomes, obese patients showed significantly higher probabilities of incontinence (p=0.003; OR: 1.41; 95% CI, 1.13-1.77) and impotency (p=0.02; OR: 1.29; 95% CI, 1.03-1.61) at 1 year. CONCLUSIONS: Perioperative outcomes of RARP in obese patients are comparable with those in nonobese patients, except for significant but small increases in operating time and EBL. Surgeons should initiate RARP procedures in obese cases after overcoming the learning curve. Further studies should be performed to evaluate the functional outcomes for obese patients undergoing RARP.
OBJECTIVE: To compare operative outcomes of robot-assisted radical prostatectomy (RARP) in obese and nonobese patients with prostate cancer. MATERIALS AND METHODS: A literature search of MEDLINE, EMBASE, Google Scholar, and the Cochrane Library was performed up to March 2014. All studies that have assessed operative outcomes of RARP in obese and nonobese patients were included. Outcome measures were perioperative and functional results, including operating time, estimated blood loss (EBL), complications, length of hospital stay (LOS), positive surgical margins (PSMs), and recovery of continence and potency. Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect model. Subgroup analysis was performed for institutions with greater experience of RARP in obese cases. RESULTS: Thirteen observational studies from 12 study population were included for 1821 obesepatients compared with 4801 nonobese patients. Operating time (p=0.0001; WMD: 24.28; 95% CI, 11.93-36.64) and EBL (p=0.003; WMD: 38.28; 95% CI, 13.45-63.11) were significantly increased in obesepatients compared with nonobese counterparts. There was no significant difference in complications, LOS, or PSM rates. Subgroup analysis for studies that have involved ≥100 obese cases showed consistent results, but the increases in operating time (9.8 minutes; 95% CI, 1.7-18 minutes) and EBL (14 mL; 95% CI, 5.0-23 mL) were much lower compared with the original analysis. As for functional outcomes, obesepatients showed significantly higher probabilities of incontinence (p=0.003; OR: 1.41; 95% CI, 1.13-1.77) and impotency (p=0.02; OR: 1.29; 95% CI, 1.03-1.61) at 1 year. CONCLUSIONS: Perioperative outcomes of RARP in obesepatients are comparable with those in nonobese patients, except for significant but small increases in operating time and EBL. Surgeons should initiate RARP procedures in obese cases after overcoming the learning curve. Further studies should be performed to evaluate the functional outcomes for obesepatients undergoing RARP.
Authors: Behzad Abbasi; Nathan M Shaw; Jason L Lui; Kevin D Li; Patrick Low; Nizar Hakam; Behnam Nabavizadeh; Benjamin N Breyer Journal: World J Urol Date: 2022-03-22 Impact factor: 3.661
Authors: Mark Fernando Neumaier; Carlos Henrique Segall; Marcelo Hisano; Flávio Eduardo Trigo Rocha; Sami Arap; Marco A Arap Journal: Int Braz J Urol Date: 2019 Jul-Aug Impact factor: 1.541
Authors: Thiago Camelo Mourão; Renato Almeida Rosa de Oliveira; Ricardo de Lima Favaretto; Thiago Borges Marques Santana; Carlos Alberto Ricetto Sacomani; Wilson Bachega; Gustavo Cardoso Guimarães; Stênio de Cássio Zequi Journal: Int Braz J Urol Date: 2022 Jan-Feb Impact factor: 1.541