The efficacy of peritoneal flap fixation on symptomatic lymphocele formation following robotic-assisted laparoscopic radical prostatectomy with pelvic lymph node dissection: a systematic review and meta-analysis

作者全名："Su, Shuai; Wang, Jue; Lei, Yi; Yi, Tong; Kang, Huayin; Bai, Bing; Wang, Delin"

作者地址："[Su, Shuai; Wang, Jue; Yi, Tong; Wang, Delin] Chongqing Med Univ, Dept Urol, Affiliated Hosp 1, Chongqing 400016, Peoples R China; [Yi, Tong] Chongqing Univ, Chongqing Emergency Med Ctr, Dept Urol, Cent Hosp, Chongqing, Peoples R China; [Wang, Jue; Lei, Yi; Kang, Huayin; Bai, Bing] Panzhihua Cent Hosp, Dept Urol, Panzhihua 617000, Sichuan, Peoples R China"

通信作者："Wang, DL (通讯作者)，Chongqing Med Univ, Dept Urol, Affiliated Hosp 1, Chongqing 400016, Peoples R China.; Bai, B (通讯作者)，Panzhihua Cent Hosp, Dept Urol, Panzhihua 617000, Sichuan, Peoples R China."

来源：INTERNATIONAL JOURNAL OF SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001164676800064

JCR分区：Q1

影响因子：12.5

年份：2024

卷号：110

期号：2

开始页：1172

结束页：1182

文献类型：Article

关键词：meta-analysis; peritoneal rotation flap; peritoneal interpolated flap; pelvic lymphadenectomy; systematic review

摘要："Background:Pelvic lymphocele is the most common complication after robot-assisted radical prostatectomy (RARP) with pelvic lymph node dissection (PLND), of which symptomatic lymphocele (sLC) ranges up to 10% and is associated with poorer perioperative outcomes. Peritoneal flap fixation (PFF) is a promising intraoperative modification to reduce sLC formation but the clinical evidence failed to reach consistency.Materials and methods:Randomized and nonrandomized comparative studies comparing postoperative sLC occurrence with or without PFF after RARP with PLND were identified through a systematic literature search via MEDLINE/PubMed, Embase, Web of Science, and CENTRAL up to July 2023. Outcome data of sLC occurrence (primary) and major perioperative events (secondary) were extracted. Mean difference and risk ratio with 95% CI were synthesized as appropriate for each outcome to determine the cumulative effect size.Results:Five RCTs and five observatory studies involving 3177 patients were finally included in the qualitative and quantitative analysis. PFF implementation significantly reduced the occurrence of sLC (RR 0.35, 95% CI: 0.24-0.50), and the specific lymphocele-related symptoms, without compromised perioperative outcomes including blood loss, operative time, and major nonlymphocele complications. The strength of the evidence was enhanced by the low risk of bias and low inter-study heterogeneity of the eligible RCTs.Conclusion:PFF warrants routine implementation after RARP with PLND to prevent or reduce postoperative sLC formation."

基金机构：Chongqing Medical University [CYYY-BSYJSCXXM-202332]

基金资助正文：This work was supported by grants from doctoral program of the first affiliated hospital of Chongqing Medical University (CYYY-BSYJSCXXM-202332).