Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: Surgical, Oncological, and Functional Outcomes: A Systematic Review

Objectives: Despite the wide diffusion of minimally invasive approaches, such as laparoscopic (LRP) and robotassisted radical prostatectomy (RALP), few studies compare the results of these techniques with the retropubic radical prostatectomy (RRP) approach. The aim of this study is to compare the surgical, functional, and oncological outcomes and cost-effectiveness of RRP, LRP, and RALP. Methods: A systematic review of the literature was performed in the PubMed and Embase databases in December 2013. A ‘freetext’ protocol using the term ‘radical prostatectomy’ was applied. A total of 16,085 records were found. The authors reviewed the records to identify comparative studies to include in the review. Results: 44 comparative studies were identified. With regard to the perioperative outcome, LRP and RALP were more time-consuming than RRP, but blood loss, transfusion rates, catheterisation time, hospitalisation duration, and complication rates were the most optimal in the laparoscopic approaches. With regard to the functional and oncological results, RALP was found to have the best