Evidence map›Paper›PMID 41733695›Full record

SynthesisWorld journal of urology2026

Peritoneal flaps for the prevention of lymphoceles after robot-assisted radical prostatectomy-a systematic review and IPD-meta-analysis of randomized controlled trials.

Gloria Baumann, Caelán Max Haney-Aubert, Victoria Luise Simone Wieland, Jiri Lehmberg, Wahid Fattal, Christian Gilfrich, Maximilian Burger, Vladimir Student, Joseph Wagner, Simon Gloger and 3 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Gloria Baumann *Medical Faculty Mannheim, Department of Urology and Urosurgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Caelán Max Haney-Aubert *Medical Faculty Mannheim, Department of Urology and Urosurgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. caelan.haney@dkfz-heidelberg.de.
Victoria Luise Simone WielandMedical Faculty Mannheim, Department of Urology and Urosurgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Jiri LehmbergDKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany.
Wahid FattalDKFZ Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany.
Christian GilfrichDepartment of Uroloogy, St. Elisabeth Hospital Straubing, Straubing, Germany.
Maximilian BurgerDepartment of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany.
Vladimir StudentDepartment of Urology, University Hospital Olomouc, Olomouc, Czech Republic.
Joseph WagnerDepartment of Urology, Hartford Healthcare Medical Group, Hartford Hospital, Hartford, CT, USA.
Simon GlogerCenter for Minimally Invasive and Robotic Urology, Augusta Hospital Bochum, Witten/Herdecke University, Bochum, Germany.
Maurice Stephan MichelMedical Faculty Mannheim, Department of Urology and Urosurgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Karl-Friedrich KowalewskiMedical Faculty Mannheim, Department of Urology and Urosurgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Manuel NeubergerMedical Faculty Mannheim, Department of Urology and Urosurgery, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLymphoceles (LCs) are one of the most common complications after robot-assisted radical prostatectomy (RARP). Peritoneal flaps (PF) have shown to possibly decrease the incidence of LCs. This individual patient data meta-analysis (IPD-MA) investigates the efficacy of PF on rates of symptomatic lymphoceles (sLCs) requiring intervention, sLCs, overall lymphoceles and perioperative complications.

methodsWe conducted a prespecified systematic review and IPD-MA (PROSPERO CRD42024519284). A database search via Medline, Web of Science, Embase, Central, ClinicalTrials.gov and the International Clinical Trials Registry Platform was performed up to December 2023. Six randomized controlled trials (RCTs) comparing PF vs. no PF during RARP with PLND were included and five RCTs provided IPD. MA was conducted using a random-effects model (two-stage model).

resultsPF significantly reduced sLCs requiring intervention as well as the rates of sLCs and overall lymphoceles. Additionally, PF significantly reduced overall complications, most likely driven by fewer lymphoceles and associated interventions. Furthermore, BMI and the presence of lymphoceles at discharge were identified as risk factors for sLCs. Subgroup analyses suggested that the protective effect of PF diminishes with increasing BMI, indicating limited benefit in patients with severe obesity.

conclusionsThe creation of PF after RARP significantly reduces sLCs without affecting the complication rate or meaningfully prolonging operative time. LCs at the time of discharge represent significant risk factors for occurrence of sLCs, indicating a possibility for closer observation for this subgroup. With the evidence provided by this IPD-MA, creation of PF should be the new standard of care to reduce LC-related morbidity.

Indexed as

LymphocelePeritoneumPostoperative ComplicationsProstatectomyRobotic Surgical ProceduresSurgical FlapsHumansMaleRandomized Controlled Trials as TopicEvidence-based surgeryLymphoceleMeta-analysisPelvic lymph node dissection (PLND)Randomized controlled trialsRobot-assisted radical prostatectomy (RARP)Surgical technique

Identifiers

PMID41733695
PMCPMC12932341

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Registered trials

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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.