比较接受 NeuroSAFE 指导的 RARP 与单独 RARP 的患者的手术、病理和功能结果。 2024 年 2 月，通过 PubMed®、Scopus® 和 Web of Science™ 进行文献检索和评估，以检索男性数据PCa (P) 接受使用 NeuroSAFE 的 RARP (I) 与不使用 NeuroSAFE 的 RARP (C) 进行对比，通过回顾性和/或前瞻性比较研究（研究）来评估手术、病理、肿瘤和功能结果 (O)。手术（手术时间 [OT]、保留神经 [NS] RARP 的数量、NeuroSAFE 后二次切除的数量）、病理 (PSM)、肿瘤（生化复发 [BCR]）和功能（术后节制和性功能恢复）对连续变量使用加权平均差（WMD），对二分变量使用奇数比（OR）对结果进行分析。总体而言，七项研究符合纳入标准（一项随机临床试验、一项前瞻性非随机试验和五项回顾性研究）有资格获得 SR 和 MA。 MA 共纳入 4,207 名患者，其中 2247 名患者 (53%) 接受 RARP 加 NeuroSAFE，1 960 名患者 (47%) 单独接受 RARP。添加 NeuroSAFE 增强了接受神经保留 (NS) RARP 的可能性（OR 5.49，95% CI 2.48-12.12，I2 = 72%）。在 NeuroSAFE 队列中，观察到最终病理学中 PSM 可能性有统计学意义的显着降低（OR 0.55，95% CI 0.39-0.79，I2 = 73%）。同样，BCR 有利于 NeuroSAFE 的可能性也降低了（OR 0.47，95% CI 0.35-0.62，I2 = 0%）。术后 12 个月时，NeuroSAFE 显着提高了无护垫的可能性（OR 2.01，95% CI 1.25-3.25，I2 = 0%）和勃起功能恢复的可能性（OR 3.50，95% CI 2.34-5.23） ，I2 = 0%）。现有证据表明，NeuroSAFE 可能代表了一种基于组织学的 NVB 保存方法，拓宽了 NS RARP 的适应症，降低了 PSM 和随后的 BCR 的可能性。此外，它可能会转化为更好的功能性术后结果。然而，目前的证据大多来自具有高偏倚风险的非随机研究。© 2024。作者，获得施普林格自然有限公司的独家许可。

To compare surgical, pathological, and functional outcomes of patients undergoing NeuroSAFE-guided RARP vs. RARP alone.In February 2024, a literature search and assessment was conducted through PubMed®, Scopus®, and Web of Science™, to retrieve data of men with PCa (P) undergoing RARP with NeuroSAFE (I) versus RARP without NeuroSAFE (C) to evaluate surgical, pathological, oncological, and functional outcomes (O), across retrospective and/or prospective comparative studies (Studies). Surgical (operative time [OT], number of nerve-sparing [NS] RARP, number of secondary resections after NeuroSAFE), pathological (PSM), oncological (biochemical recurrence [BCR]), and functional (postoperative continence and sexual function recovery) outcomes were analyzed, using weighted mean difference (WMD) for continuous variables and odd ratio (OR) for dichotomous variables.Overall, seven studies met the inclusion criteria (one randomized clinical trial, one prospective non-randomized trial and five retrospective studies) and were eligible for SR and MA. A total of 4,207 patients were included in the MA, with 2247 patients (53%) undergoing RARP with the addition of NeuroSAFE, and 1 960 (47%) receiving RARP alone. The addition of NeuroSAFE enhanced the likelihood of receiving a nerve-sparing (NS) RARP (OR 5.49, 95% CI 2.48-12.12, I2 = 72%). In the NeuroSAFE cohort, a statistically significant reduction in the likelihood of PSM at final pathology (OR 0.55, 95% CI 0.39-0.79, I2 = 73%) was observed. Similarly, a reduced likelihood of BCR favoring the NeuroSAFE was obtained (OR 0.47, 95% CI 0.35-0.62, I2 = 0%). At 12-month postoperatively, NeuroSAFE led to a significantly higher likelihood of being pad-free (OR 2.01, 95% CI 1.25-3.25, I2 = 0%), and of erectile function recovery (OR 3.50, 95% CI 2.34-5.23, I2 = 0%).Available evidence suggests that NeuroSAFE might represent a histologically based approach to NVB preservation, broadening the indications of NS RARP, reducing the likelihood of PSM and subsequent BCR. In addition, it might translate into better functional postoperative outcomes. However, the current body of evidence is mostly derived from non-randomized studies with a high risk of bias.© 2024. The Author(s), under exclusive licence to Springer Nature Limited.