nach oben

Journal of Robotic Surgery

Erschienen in:

23.02.2018 | Original Article

Prostatectomies for localized prostate cancer: a mixed comparison network and cumulative meta-analysis

verfasst von: Kannan Sridharan, Gowri Sivaramakrishnan

Erschienen in: Journal of Robotic Surgery | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

No consensus has been attained regarding the utility of open retropubic radical prostatectomy (RRP), laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALRP) for localized prostate cancer (PCa). We carried out a network meta-analysis and cumulative meta-analysis comparing RRP, LRP and RALRP on peri-operative and functional outcome measures. Electronic databases were searched for either randomized clinical trials or cohort studies comparing RALRP either with LRP or RRP in patients with localized PCa. Outcome measures were as follows: overall, pT2 and pT3-positive surgical margins (PSMs); biochemical recurrence (BCR); complication rates; estimated blood loss; blood transfusion rate; continence and potency rates; duration of catheterization and hospital stay. Publication bias, risk of bias and inconsistency were assessed. Inverse heterogeneity model was used for analysis. A total of 45 studies were included for the final analysis. We observed that RALRP and LRP did not differ significantly from RRP with regard to the following outcomes: overall PSM; pT2 and pT3 PSMs; OT; complication rate; continence and potency rates; total blood loss and hospital stay. Duration of catheterization was significantly shorter in RALRP than LRP and RRP while significant reductions in the need for blood transfusion and BCR were observed for both RALRP and LRP in comparison with RRP. To conclude, similar functional, operative and oncologic outcomes were observed for both RALRP and LRP compared to RRP.

Nur mit Berechtigung zugänglich

Cancer stats facts: prostate cancer. https://seer.cancer.gov/statfacts/html/prost.html. Accessed 15 April 2017

Moul JW, Wu H, Sun L, McLeod DG, Amling C, Lance R et al (2002) Epidemiology of radical prostatectomy for localized prostate cancer in the era of prostate-specific antigen: an overview of the Department of Defense Center for Prostate Disease Research national database. Surgery 132:213–219CrossRef

Lepor H (2005) A review of surgical techniques for radical prostatectomy. Rev Urol 7:S11–S17PubMedPubMedCentral

Mayer E, Darzi A (2016) Innovation and surgical clinical trials. Lancet 388:1027–1028CrossRef

Finkelstein J, Eckersberger E, Sadri H, Taneja SS, Lepor H, Djavan B (2010) Open versus laparoscopic versus robot-assisted laparoscopic prostatectomy: the European and US experience. Rev Urol 12:35–43PubMedPubMedCentral

Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A et al (2012) Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 62:405–417CrossRef

Ficarra V, Novara G, Ahlering TE, Costello A, Eastham JA, Graefen M et al (2012) Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol 62:418–430CrossRef

Agarwal G, Valderrama O, Luchey AM, Pow-Sang JM (2015) Robot-assisted laparoscopic radical prostatectomy. Cancer Control 22:283–290CrossRef

Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Guazzoni G et al (2009) Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol 55:1037–1063CrossRef

10.

Cipriani A, Higgins JP, Geddes JR, Salanti G (2013) Conceptual and technical challenges in network meta-analysis. Ann Intern Med 159:130–137CrossRef

11.

Hutton B, Salanti G, Caldwell DM et al (2015) The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med 162:777–784CrossRef

12.

Higgins JPT, Green S (eds) (2017) Cochrane handbook for systematic reviews of interventions, 5.1.0 edn. www.cochrane-handbook.org. Accessed 11 April 2017

13.

The Newcastle–Ottawa scale for assessing the quality of nonrandomized studies in meta-analysis. http://www.medicine.mcgill.ca/rtamblyn/Readings%5CThe%20Newcastle%20-%20Scale%20for%20assessing%20the%20quality%20of%20nonrandomised%20studies%20in%20meta-analyses.pdf. Accessed 15 April 2017

14.

Rucker G, Schwarzer G (2015) Ranking treatments in frequentist network meta-analysis works without resampling methods. BMC Med Res Methodol 15:8CrossRef

15.

Higgins JPT, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558CrossRef

16.

Van Rhee, HJ, Surmond R, Hak T (2017) User manual for meta-essentials: workbooks for meta-analysis (version 1.0). Erasmus Research Institute of Management, Rotterdam, The Netherlands. http://www.erim.eur.nl/research-support/meta-essentials. Accessed 12 March 2017

17.

Asimakopoulos AD, Pereira Fraga CT, Annino F, Pasqualetti P, Calado AA, Mugnier C (2011) Randomized comparison between laparoscopic and robot-assisted nerve-sparing radical prostatectomy. J Sex Med 8:1503–1512CrossRef

18.

Asimakopoulos AD, Miano R, Di Lorenzo N, Spera E, Vespasiani G, Mugnier C (2013) Laparoscopic versus robot-assisted bilateral nerve-sparing radical prostatectomy: comparison of pentafecta rates for a single surgeon. Surg Endosc 27:4297–4304CrossRef

19.

Barocas DA, Salem S, Kordan Y, Herrell SD, Chang SS, Clark PE, Davis R, Baumgartner R, Phillips S, Cookson MS, Smith JA Jr (2010) Robotic assisted laparoscopic prostatectomy versus radical retropubic prostatectomy for clinically localized prostate cancer: comparison of short-term biochemical recurrence-free survival. J Urol 183:990–996CrossRef

20.

Beauval JB, Roumiguié M, Ouali M, Doumerc N, Thoulouzan M, Mazerolles C, Rischmann P, Malavaud B, Soulié M (2015) A prospective trial comparing consecutive series of open retropubic and robot-assisted laparoscopic radical prostatectomy in a centre: oncologic and functional outcomes. Prog Urol 25:370–378CrossRef

21.

Berge V, Berg RE, Hoff JR, Wessel N, Diep LM, Karlsen SJ, Eri LM (2013) A prospective study of transition from laparoscopic to robot-assisted radical prostatectomy: quality of life outcomes after 36-month follow-up. Urology 81:781–786CrossRef

22.

Bier S, Hennenlotter J, Rausch S, Aufderklamm S, Martzog JC, Stenzl A, Schwentner C, Todenhöfer T (2016) Return to work and normal daily life activity after open and robot-assisted radical prostatectomy—a single surgeon analysis. Urol Int 96:280–286CrossRef

23.

Busch J, Gonzalgo ML, Leva N, Ferrari M, Cash H, Kempkensteffen C, Hinz S, Miller K, Magheli A (2015) Matched comparison of robot-assisted, laparoscopic and open radical prostatectomy regarding pathologic and oncologic outcomes in obese patients. World J Urol 33:397–402CrossRef

24.

Di Pierro GB, Baumeister P, Stucki P, Beatrice J, Danuser H, Mattei A (2011) A prospective trial comparing consecutive series of open retropubic and robot-assisted laparoscopic radical prostatectomy in a centre with a limited caseload. Eur Urol 59:1–6CrossRef

25.

Ficarra V, Novara G, Fracalanza S, D’Elia C, Secco S, Iafrate M, Cavalleri S, Artibani W (2009) A prospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int 104:534–539CrossRef

26.

Haglind E, Carlsson S, Stranne J, Wallerstedt A, Wilderäng U, Thorsteinsdottir T, Lagerkvist M, Damber JE, Bjartell A, Hugosson J, Wiklund P, Steineck G, LAPPRO Steering Committee (2015) Urinary incontinence and erectile dysfunction after robotic versus open radical prostatectomy: a prospective, controlled, nonrandomised trial. Eur Urol 68:216–225CrossRef

27.

Hohwü L, Borre M, Ehlers L, Venborg Pedersen K (2011) A short-term cost-effectiveness study comparing robot-assisted laparoscopic and open retropubic radical prostatectomy. J Med Econ 14:403–409CrossRef

28.

Joo EY, Moon YJ, Yoon SH, Chin JH, Hwang JH, Kim YK (2016) Comparison of acute kidney injury after robot-assisted laparoscopic radical prostatectomy versus retropubic radical prostatectomy: a propensity score matching analysis. Medicine (Baltimore) 95:e2650CrossRef

29.

Krambeck AE, DiMarco DS, Rangel LJ, Bergstralh EJ, Myers RP, Blute ML, Gettman MT (2009) Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot-assisted techniques. BJU Int 103:448–453CrossRef

30.

Lee D, Choi SK, Park J, Shim M, Kim A, Lee S, Song C, Ahn H (2015) Comparative analysis of oncologic outcomes for open vs. robot-assisted radical prostatectomy in high-risk prostate cancer. Korean. J Urol 56:572–579

31.

Ludovico GM, Dachille G, Pagliarulo G, D’Elia C, Mondaini N, Gacci M, Detti B, Malossini G, Bartoletti R, Cai T (2013) Bilateral nerve sparing robotic-assisted radical prostatectomy is associated with faster continence recovery but not with erectile function recovery compared with retropubic open prostatectomy: the need for accurate selection of patients. Oncol Rep 29:2445–2450CrossRef

32.

Lott FM, Favorito LA (2015) Is previous experience in laparoscopic necessary to perform robotic radical prostatectomy? A comparative study with robotic and the classic open procedure in patients with prostate cancer. Acta Cirúrgica Brasileira 30:229–234CrossRef

33.

Leyh-Bannurah SR, Hansen J, Isbarn H, Steuber T, Tennstedt P, Michl U, Schlomm T, Haese A, Heinzer H, Huland H, Graefen M, Budäus L (2014) Open and robot-assisted radical retropubic prostatectomy in men receiving ongoing low-dose aspirin medication: revisiting an old paradigm? BJU Int 114:396–403PubMed

34.

Menon M, Shrivastava A, Tewari A, Sarle R, Hemal A, Peabody JO, Vallancien G (2002) Laparoscopic and robot assisted radical prostatectomy: establishment of a structured program and preliminary analysis of outcomes. J Urol 168:945–949CrossRef

35.

Mustafa M, Pettaway CA, Davis JW, Pisters L (2015) Robotic or open radical prostatectomy after previous open surgery in the pelvic region. Korean J Urol 56:131–137CrossRef

36.

Mustafa M, Davis JW, Gorgel SN, Pisters L (2017) Robotic or open radical prostatectomy in men with previous transurethral resection of prostate. Urol J 14:2955–2960PubMed

37.

Nelson B, Kaufman M, Broughton G, Cookson MS, Chang SS, Herrell SD, Baumgartner RG, Smith JA Jr (2007) Comparison of length of hospital stay between radical retropubic prostatectomy and robotic assisted laparoscopic prostatectomy. J Urol 177:929–931CrossRef

38.

Tewari A, Srivasatava A, Menon M, Members of the VIP Team (2003) A prospective comparison of radical retropubic and robot-assisted prostatectomy: experience in one institution. BJU Int 92:205–210CrossRef

39.

Tobias-Machado M, Mitre AI, Rubinstein M, Costa EF, Hidaka AK (2016) Robotic-assisted radical prostatectomy learning curve for experienced laparoscopic surgeons: does it really exist? Int Braz J Urol 42:83–89CrossRef

40.

Tozawa K, Yasui T, Umemoto Y, Mizuno K, Okada A, Kawai N, Takahashi S, Kohri K (2014) Pitfalls of robot-assisted radical prostatectomy: a comparison of positive surgical margins between robotic and laparoscopic surgery. Int J Urol 21:976–979CrossRef

41.

Wallerstedt A, Tyritzis SI, Thorsteinsdottir T, Carlsson S, Stranne J, Gustafsson O, Hugosson J, Bjartell A, Wilderäng U, Wiklund NP, Steineck G, Haglind E, LAPPRO Steering Committee (2015) Short-term results after robot-assisted laparoscopic radical prostatectomy compared to open radical prostatectomy. Eur Urol 67:660–670CrossRef

42.

Willis DL, Gonzalgo ML, Brotzman M, Feng Z, Trock B, Su LM (2012) Comparison of outcomes between pure laparoscopic vs robot-assisted laparoscopic radical prostatectomy: a study of comparative effectiveness based upon validated quality of life outcomes. BJU Int 109:898–905CrossRef

43.

Yaxley JW, Coughlin GD, Chambers SK, Occhipinti S, Samaratunga H, Zajdlewicz L, Dunglison N, Carter R, Williams S, Payton DJ, Perry-Keene J, Lavin MF, Gardiner RA (2016) Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet 388:1057–1066CrossRef

44.

Joseph JV, Vicente I, Madeb R, Erturk E, Patel HR (2005) Robot-assisted vs pure laparoscopic radical prostatectomy: are there any differences? BJU Int 96:39–42CrossRef

45.

Kasraeian A, Barret E, Chan J, Sanchez-Salas R, Validire P, Cathelineau X, Rozet F, Galiano M, Vallancien G (2011) Comparison of the rate, location and size of positive surgical margins after laparoscopic and robot-assisted laparoscopic radical prostatectomy. BJU Int 108:1174–1178CrossRef

46.

Ploussard G, de la Taille A, Moulin M, Vordos D, Hoznek A, Abbou CC, Salomon L (2014) Comparisons of the perioperative, functional, and oncologic outcomes after robot-assisted versus pure extraperitoneal laparoscopic radical prostatectomy. Eur Urol 65:610–619CrossRef

47.

Porpiglia F, Morra I, Lucci Chiarissi M, Manfredi M, Mele F, Grande S, Ragni F, Poggio M, Fiori C (2013) Randomised controlled trial comparing laparoscopic and robot-assisted radical prostatectomy. Eur Urol 63:606–614CrossRef

48.

Schroeck FR, Sun L, Freedland SJ, Albala DM, Mouraviev V, Polascik TJ, Moul JW (2008) Comparison of prostate-specific antigen recurrence-free survival in a contemporary cohort of patients undergoing either radical retropubic or robot-assisted laparoscopic radical prostatectomy. BJU Int 102:28–32CrossRef

49.

Wolanski P, Chabert C, Jones L, Mullavey T, Walsh S, Gianduzzo T (2012) Preliminary results of robot-assisted laparoscopic radical prostatectomy (RALP) after fellowship training and experience in laparoscopic radical prostatectomy (LRP). BJU Int 110:64–70CrossRef

50.

Agreda F, Raventos C, Planas J, Trilla E, Morote J (2014) Comparison of the initial robot-assisted radical prostatectomy results with laparoscopic radical prostatectomy. Arch Esp Urol 67:185–190PubMed

51.

Papachristos A, Basto M, Te Marvelde L, Moon D (2015) Laparoscopic versus robotic-assisted radical prostatectomy: an Australian single-surgeon series. ANZ J Surg 85:154–158CrossRef

52.

Park J, Yoo DS, Song C, Park S, Park S, Kim SC, Cho Y, Ahn H (2014) Comparison of oncological outcomes between retropubic radical prostatectomy and robot-assisted radical prostatectomy: an analysis stratified by surgical experience. World J Urol 32:193–199CrossRef

53.

Philippou P, Waine E, Rowe E (2012) Robot-assisted laparoscopic prostatectomy versus open: comparison of the learning curve of a single surgeon. J Endourol 26:1002–1008CrossRef

54.

Punnen S, Meng MV, Cooperberg MR, Greene KL, Cowan JE, Carroll PR (2013) How does robot-assisted radical prostatectomy (RARP) compare with open surgery in men with high-risk prostate cancer? BJU Int 112:E314–E320CrossRef

55.

Rozet F, Jaffe J, Braud G, Harmon J, Cathelineau X, Barret E, Vallancien G (2007) A direct comparison of robotic assisted versus pure laparoscopic radical prostatectomy: a single institution experience. J Urol 178:478–482CrossRef

56.

Hakimi AA, Blitstein J, Feder M, Shapiro E, Ghavamian R (2009) Direct comparison of surgical and functional outcomes of robotic-assisted versus pure laparoscopic radical prostatectomy: single-surgeon experience. Urology 73:119–123CrossRef

57.

Shapiro EY, Scarberry K, Patel T, Bergman A, Ahn JJ, Sahi N, RoyChoudhury A, Deutch I, McKiernan JM, Benson MC, Badani KK (2014) Comparison of robot-assisted and open retropubic radical prostatectomy for risk of biochemical progression in men with positive surgical margins. J Endourol 28:208–213CrossRef

58.

Suh YS, Jang HJ, Song W, Lee HW, Kim HS, Jeon HG, Jeong BC, Seo SI, Jeon SS, Choi HY, Lee HM (2014) Location of positive surgical margin and its association with biochemical recurrence rate do not differ significantly in four different types of radical prostatectomy. Korean J Urol 55:802–807CrossRef

59.

Trabulsi EJ, Zola JC, Colon-Herdman A, Heckman JE, Gomella LG, Lallas CD (2011) Minimally invasive radical prostatectomy: transition from pure laparoscopic to robotic-assisted radical prostatectomy. Arch Esp Urol 64:823–829PubMed

60.

Iseki R, Ohori M, Hatano T, Tachibana M (2012) Urinary incontinence in early experience with robot-assisted laparoscopic prostatectomy-comparison with radical retropubic prostatectomy. Hinyokika Kiyo 58:409–414PubMed

61.

Koo KC, Tuliao P, Yoon YE, Chung BH, Hong SJ, Yang SC, Rha KH (2014) Robot-assisted radical prostatectomy in the Korean population: a 5-year propensity-score matched comparative analysis versus open radical prostatectomy. Int J Urol 21:781–785CrossRef

62.

Moran PS, O’Neill M, Teljeur C, Flattery M, Murphy LA, Smyth G, Ryan M (2013) Robot-assisted radical prostatectomy compared with open and laparoscopic approaches: a systematic review and meta-analysis. Int J Urol 20:312–321CrossRef

63.

Robertson C, Close A, Fraser C, Gurung T, Jia X, Sharma P, Vale L, Ramsay C, Pickard R (2013) Relative effectiveness of robot-assisted and standard laparoscopic prostatectomy as alternatives to open radical prostatectomy for treatment of localised prostate cancer: a systematic review and mixed treatment comparison meta-analysis. BJU Int 112:798–812CrossRef

64.

Seo H-J, Lee NR, Son SK, Kim DK, Rha KH, Lee SH (2016) Comparison of robot-assisted radical prostatectomy and open radical prostatectomy outcomes: a systematic review and meta-analysis. Yonsei Med J 57:1165–1177CrossRef

65.

Novara G, Ficarra V, Mocellin S, Ahlering TE, Carroll PR, Graefen M, Guazzoni G, Menon M, Patel VR, Shariat SF, Tewari AK, Van Poppel H, Zattoni F, Montorsi F, Mottrie A, Rosen RC, Wilson TG (2012) Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy. Eur Urol 62:382–404CrossRef

66.

Close A, Robertson C, Rushton S, Shirley M, Vale L, Ramsay C, Pickard R (2013) Comparative cost-effectiveness of robot-assisted and standard laparoscopic prostatectomy as alternatives to open radical prostatectomy for treatment of men with localised prostate cancer: a health technology assessment from the perspective of the UK National Health Service. Eur Urol 64:361–369CrossRef

Titel: Prostatectomies for localized prostate cancer: a mixed comparison network and cumulative meta-analysis
verfasst von: Kannan Sridharan
Gowri Sivaramakrishnan
Publikationsdatum: 23.02.2018
Verlag: Springer London
Erschienen in: Journal of Robotic Surgery / Ausgabe 4/2018
Print ISSN: 1863-2483
Elektronische ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-018-0791-8

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Prostatectomies for localized prostate cancer: a mixed comparison network and cumulative meta-analysis

Abstract

Neu im Fachgebiet Chirurgie

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

Fehlerkultur in der Medizin – Offenheit zählt!

Mehr Frauen im OP – weniger postoperative Komplikationen

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

Update Chirurgie

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

S2e-Leitlinie „Distale Radiusfraktur“

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2018

Patient perceptions of acute pain and activity disruption following inguinal hernia repair: a propensity-matched comparison of robotic-assisted, laparoscopic, and open approaches

A single-incision thoracoscopic and robotic hybrid procedure via the axillary approach in a patient with thyroid, lung, and mediastinal tumors

Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis

Operative time and length of stay is similar between robotic assisted and laparoscopic colon and rectal resections

Transoral robotic surgery for oncocytic ductal cyst of hypopharynx: a lesion with a high probability of recurrence

First 100 consecutive robotic inguinal hernia repairs at a Veterans Affairs hospital

Update Chirurgie