Evidence map›Paper›PMID 37014288›Full record

SynthesisBJU international2023

Role of pelvic drain and timing of urethral catheter removal following RARP: a systematic review and meta-analysis.

Takafumi Yanagisawa, Tatsushi Kawada, Hadi Mostafaei, Reza Sari Motlagh, Fahad Quhal, Ekaterina Laukhtina, Pawel Rajwa, Markus von Deimling, Alberto Bianchi, Maximilian Pallauf and 5 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in BJU international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 11 institutions in 11 countries.

Takafumi YanagisawaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-7410-0712
Tatsushi KawadaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-8369-9712
Hadi MostafaeiDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0001-5596-1771
Reza Sari MotlaghDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-3819-9911
Fahad QuhalDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Ekaterina LaukhtinaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-8953-0272
Pawel RajwaDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0003-4073-6584
Markus von DeimlingDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Alberto BianchiDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Maximilian PallaufDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.ORCID 0000-0002-8496-4506
Benjamin PradereDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Pierre I KarakiewiczCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada.
Jun MikiDepartment of Urology, The Jikei University School of Medicine, Tokyo, Japan.ORCID 0000-0002-4638-8640
Takahiro KimuraDepartment of Urology, The Jikei University School of Medicine, Tokyo, Japan.
Shahrokh F ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Comprehensive Cancer Center Vienna · ATJikei University School of Medicine · JPAl-Ahliyya Amman University · JOKing Fahad Specialist Hospital · SAMcGill University Health Centre · CAMedical University of Silesia · PLOkayama University · JPParacelsus Medical University · ATTabriz University of Medical Sciences · IRUniversität Hamburg · DEUniversity of Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess the clinical value of routine pelvic drain (PD) placement and early removal of urethral catheter (UC) in patients undergoing robot-assisted radical prostatectomy (RARP), as perioperative management such as the necessity of PD or optimal timing for UC removal remains highly variable.

methodsMultiple databases were searched for articles published before March 2022 according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Studies were deemed eligible if they investigated the differential rate of postoperative complications between patients with/without routine PD placement and with/without early UC removal, defined as UC removal at 2-4 days after RARP.

resultsOverall, eight studies comprising 5112 patients were eligible for the analysis of PD placement, and six studies comprising 2598 patients were eligible for the analysis of UC removal. There were no differences in the rate of any complications (pooled odds ratio [OR] 0.89, 95% confidence interval [CI] 0.78-1.00), severe complications (Clavien-Dindo Grade ≥III; pooled OR 0.95, 95% CI 0.54-1.69), all and/or symptomatic lymphocele (pooled OR 0.82, 95% CI 0.50-1.33; and pooled OR 0.58, 95% CI 0.26-1.29, respectively) between patients with or without routine PD placement. Furthermore, avoiding PD placement decreased the rate of postoperative ileus (pooled OR 0.70, 95% CI 0.51-0.91). Early removal of UC resulted in an increased likelihood of urinary retention (OR 6.21, 95% CI 3.54-10.9) in retrospective, but not in prospective studies. There were no differences in anastomosis leakage and early continence rates between patients with or those without early removal of UC.

conclusionsThere is no benefit for routine PD placement after standard RARP in the published articles. Early removal of UC seems possible with the caveat of the increased risk of urinary retention, while the effect on medium-term continence is still unclear. These data may help guide the standardisation of postoperative procedures by avoiding unnecessary interventions, thereby reducing potential complications and associated costs.

Indexed as

Robotic Surgical ProceduresUrinary RetentionHumansMalePostoperative ComplicationsProspective StudiesProstatectomyRetrospective StudiesUrinary Catheterspelvic drainperioperative complicationprostate cancerrobot-assisted radical prostatectomyurethral catheter

Identifiers

PMID37014288
OpenAlexW4362522468

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.