Comparison of efficacy and safety of conventional laparoscopic radical prostatectomy by the transperitoneal versus extraperitoneal procedure

Abstract

Worldwide, prostate cancer (PCa) is the second most common malignancy in males. We undertook a meta-analysis to compare the efficacy and safety of conventional laparoscopic radical prostatectomy with a transperitoneal (TLRP) approach, versus that of an extraperitoneal (ELRP) approach, for treatment of localized PCa. A comprehensive literature search retrieved 14 publications, with a total of 1715 patients. Meta-analysis of these studies showed that an ELRP approach was associated with a significantly shorter postoperative catheterization time (MD: 1.99; 95% CI: 0.52 to 3.54; P = 0.008), less blood transfusion rate (OR: 2.05; 95% CI: 1.03 to 4.06; P = 0.04), shorter intestinal function recovery time (MD: 0.08; 95% CI: 0.52 to 1.09; P < 0.0001) and shorter hospitalization days (MD: 2.71; 95% CI: 1.03 to 4.39; P = 0.002). In addition, our results showed no statistically significant differences between the two groups in operation time (MD: 19.39; 95% CI: -6.67 to 45.44; P = 0.014), intraoperative blood loss (MD: 4.89; 95% CI: -105.00 to 114.79; P = 0.93) and total complication rate (RR: 1.22; 95% CI: 0.86 to 1.74; P = 0.27). In summary, our meta-analysis showed that ELRP is likely to be a safe and feasible alternative for localized PCa patients compared with TLRP.