Background: This systematic review and meta-analysis investigated whether peritoneal interposition flap (PIF) prevent lymphocele formation after robot-assisted radical prostatectomy with extended pelvic lymph node dissection. Materials and Methods: We performed a systematic review and cumulative meta-analysis of the primary outcomes according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Assessing the Methodological Quality of Systematic Reviews guidelines and risk-of-bias tool. Five databases, including Medline, PubMed, Cochrane Library, Scopus, and Web of Science, were systematically searched. The time frame of the search was set from the creation of the database to February 2023. Results: Meta-analysis of symptomatic lymphoceles (sLCs) rates revealed significant difference between PIF and no PIF group (eight studies pooled; p = 0.005), The sLCs rates account for 2.6% (28/1074) and 7.1% (85/1186) in the PIF and no PIF group, respectively. The resulting odds ratio was 0.34 (95% confidence interval: 0.16-0.73), taking into account the heterogeneity of these studies (Q = 14.32, p = 0.05; I2 = 51%). Conclusion: PIF is an effective intraoperative modification on the prevention or reduction of sLC, which is worthy of further clinical promotion. Systematic Review Registration: National Institute for Health and Care Research, identifier CRD42022364461.

中文翻译：

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腹膜介入皮瓣在机器人辅助根治性前列腺切除术和盆腔淋巴结切除术中预防症状性淋巴肿大的效果：荟萃分析和系统评价。

背景：本系统回顾和荟萃分析调查了腹膜介入皮瓣（PIF）是否可以预防机器人辅助根治性前列腺切除术和扩大盆腔淋巴结清扫术后淋巴囊肿的形成。材料和方法：我们根据系统评价和荟萃分析的首选报告项目、评估系统评价指南和偏倚风险工具的方法学质量，对主要结果进行了系统评价和累积荟萃分析。系统地检索了 Medline、PubMed、Cochrane Library、Scopus 和 Web of Science 等五个数据库。搜索的时间范围设定为从数据库创建到 2023 年 2 月。结果：有症状的淋巴肿大 (sLC) 发生率的荟萃分析显示，PIF 组和无 PIF 组之间存在显着差异（汇总了 8 项研究；p = 0.005），在 PIF 组和无 PIF 组中，sLC 率分别占 2.6% (28/1074) 和 7.1% (85/1186)。考虑到这些研究的异质性（Q = 14.32，p = 0.05；I2 = 51%），得出的比值比为 0.34（95% 置信区间：0.16-0.73）。结论：PIF是预防或减少sLC的有效术中改良方法，值得临床进一步推广。系统审查注册：国家健康与护理研究所，标识符 CRD42022364461。