Dados do Trabalho

Título

PERITONEAL FLAP AS PREVENTION IN THE FORMATION OF SYMPTOMATIC LYMPHOCELES IN ROBOTIC RADICAL PROSTATECTOMY WITH PELVIC LYMPHADENECTOMY: A META-ANALYSIS

Introdução e Objetivo

Lymphocele is one of the most common complications of robotic radical prostatectomy with pelvic lymphadenectomy. Using a peritoneal interposition flap (PIF) with windows that allow fluid flow from the pelvis to the abdominal cavity decreases the incidence of lymphoceles. This study aims to evaluate the impact of peritoneal flaps on the formation of symptomatic lymphoceles in patients undergoing robotic radical prostatectomy with pelvic lymphadenectomy.

Método

We performed a systematic search and meta-analysis with articles searched in Pubmed, Embase and Cochrane comparing robotic radical prostatectomy and pelvic lymphadenectomy with peritoneal flap (intervention group) or without peritoneal interposition flap (control group). A subgroup consisting of 4 randomized studies was analyzed. The primary outcome was symptomatic lymphocele formation. P-values ​​< 0.05 were considered statistically significant.  

Resultados

We included eight studies with 2397 patients, of which 1143 underwent peritoneal flap surgery. The rate of symptomatic lymphoceles was 6.69% and 2.09% in the control and intervention groups (Figure 1A), respectively, showing a significantly relevant difference (OR 0.30; 95% CI 0.19-0.47; p<0.00001; I²=31 %). The subgroup analysis of randomized clinical trials (Figure 1B) showed a rate of symptomatic lymphoceles of 7.82% and 3.62% in the control and intervention groups, respectively, also showing a statistically significant difference (OR 0.45; CI 0.27-0.77; p=0.003; I²=24%).

Conclusão

Our results suggest that using a peritoneal flap decreases the rate of symptomatic lymphocele formation in patients undergoing robotic radical prostatectomy with pelvic lymphadenectomy, improving the quality of the postoperative period and patient recovery.