Peritoneal interposition flap reduces symptomatic lymphocele following transperitoneal robot-assisted radical prostatectomy and pelvic lymph node dissection:An updated meta-analysis  

作　　者：João Henrique Sendrete de Pinho Lorrane Vieira Siqueira Riscado João Padua Manzano 

机构地区：[1]Faculty of Medicine of the Federal University of Juiz de Fora,Minas Gerais,Brazil [2]Faculty of Medicine of the Federal University of São Paulo,São Paulo,Brazil

出　　处：《Current Urology》2024年第3期167-176,共10页当代泌尿学（英文）

摘　　要：Background Robot-assisted radical prostatectomy with intraoperative pelvic lymph node dissection is the criterion standard for surgical treatment of nonmetastatic intermediate-and high-risk prostate cancer.However,this method is associated with symptomatic lymphocele(SLC),which is an important morbidity factor.To overcome this complication,several modifications of the technique have been developed,including the peritoneal interposition flap(PIF).We performed an updated systematic review and meta-analysis to investigate the efficacy and safety of this technique for preventing SLC and lymphocele(LC)formation.Materials and methods Searches were performed using databases and references from included studies and previous systematic reviews.Only randomized controlled trials and nonrandomized cohorts were included.Primary outcomes were the incidence of SLC and LC formation,and safety outcomes were defined as operation time,estimated blood loss,length of hospital stay,and urinary incontinence.Quality assessment was performed using the Newcastle-Ottawa Scale and Cochrane Collaboration's tool.Pooled treatment effects were estimated using odds ratios with 95%confidence intervals(CIs)for binary endpoints.Heterogeneity was examined using Cochran's Q test and I2 statistics;p values<0.10 and I2>25%were considered significant for heterogeneity.We used Mantel-Haenszel fixed-effect models in the analyses with low heterogeneity.Otherwise,the DerSimonian and Laird random-effects model was used.Results The initial search yielded 510 results.After the removal of duplicate records and application of the exclusion criterion,9 studies were fully reviewed for eligibility.Three randomized controlled trials and 5 retrospective cohorts met all the inclusion criteria,comprising 2261 patients,of whom 1073(47.4%)underwent PIF.Six studies reported a significant reduction in SLC in the PIF group,and 3 of the 4 studies reported LC formation yielded significant results in preventing this complication.The incidence of SLC and LC formation in a follo

关 键 词：Robot-assisted radical prostatectomy LYMPHOCELE Peritoneal reapproximation Peritoneal interpolated flap META-ANALYSIS 

分 类 号：R697.32[医药卫生—泌尿科学]