Robot-assisted radical prostatectomy compared with open and laparoscopic approaches: A systematic review and meta-analysis

Medline and Embase were searched for studies comparing robot-assisted radical prostatectomy with open prostatectomy and conventional laparoscopic prostatectomy. Random effects meta-analysis was used to calculate a pooled estimate of effect. The 95% prediction intervals are also reported. One randomized study and 50 observational studies were identified. The results show that compared with open surgery, robot-assisted surgery is associated with fewer positive surgical margins for pT2 tumors (relative risk 0.63, 95% confidence interval 0.49-0.81, P<0.001) and improved outcomes for sexual function at 12months (relative risk 1.60, 95% confidence interval 1.33-1.93, P=<0.001), and, to a lesser extent, urinary function at 12months (relative risk 1.06, 95% confidence interval 1.02-1.11, P