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Direct comparison of surgical and functional outcomes of robotic-assisted versus pure laparoscopic radical prostatectomy: single-surgeon experience.
Urology. 2009 Jan; 73(1):119-23.U

Abstract

OBJECTIVES

To compare the perioperative and functional outcomes of laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic prostatectomy (RALP) in a single-surgeon series. Robotic assistance aids the laparoscopically naive surgeon in performing minimally invasive prostate surgery by offering superior visualization and dexterity.

METHODS

The initial 75 patients with >/=12 months of functional data who had undergone RALP by a single surgeon were selected. These were compared with 75 patients who had undergone LRP from a confidential database of the same surgeon experienced in LRP toward the end of his experience with this modality (>300 cases).

RESULTS

The patients in both groups were similar with respect to age, preoperative prostate-specific antigen level, biopsy Gleason score, pathologic stage, and positive margin rate. Statistically significant differences were noted in favor of RALP vs LRP with regard to operative time (199 vs 232 minutes, P < .001), intraoperative blood loss (230 vs 311 mL, P = .004), and length of stay (1.95 vs 3.4 days, P < .0001). The 12-month continence rate was 89% after LRP and 93.3% after RALP (P = .56). The potency rate was 71.1% and 76.5% at 12 months after LRP and RALP (P = .64) for a bilateral nerve-sparing procedure, respectively.

CONCLUSIONS

Our initial experience has revealed that RALP is an equivalent, if not a superior, minimally invasive surgical option for localized prostate cancer with less blood loss and a shorter operative time and length of stay. Although the potency and continence rates were comparable, a trend was noted toward a faster return of functional outcomes in our early RALP experience.

Authors+Show Affiliations

Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18952268

Citation

Hakimi, A Ari, et al. "Direct Comparison of Surgical and Functional Outcomes of Robotic-assisted Versus Pure Laparoscopic Radical Prostatectomy: Single-surgeon Experience." Urology, vol. 73, no. 1, 2009, pp. 119-23.
Hakimi AA, Blitstein J, Feder M, et al. Direct comparison of surgical and functional outcomes of robotic-assisted versus pure laparoscopic radical prostatectomy: single-surgeon experience. Urology. 2009;73(1):119-23.
Hakimi, A. A., 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(1), 119-23. https://doi.org/10.1016/j.urology.2008.08.491
Hakimi AA, et al. Direct Comparison of Surgical and Functional Outcomes of Robotic-assisted Versus Pure Laparoscopic Radical Prostatectomy: Single-surgeon Experience. Urology. 2009;73(1):119-23. PubMed PMID: 18952268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Direct comparison of surgical and functional outcomes of robotic-assisted versus pure laparoscopic radical prostatectomy: single-surgeon experience. AU - Hakimi,A Ari, AU - Blitstein,Jeffrey, AU - Feder,Marc, AU - Shapiro,Edan, AU - Ghavamian,Reza, Y1 - 2008/10/26/ PY - 2008/04/29/received PY - 2008/07/18/revised PY - 2008/08/26/accepted PY - 2008/10/28/pubmed PY - 2009/2/3/medline PY - 2008/10/28/entrez SP - 119 EP - 23 JF - Urology JO - Urology VL - 73 IS - 1 N2 - OBJECTIVES: To compare the perioperative and functional outcomes of laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic prostatectomy (RALP) in a single-surgeon series. Robotic assistance aids the laparoscopically naive surgeon in performing minimally invasive prostate surgery by offering superior visualization and dexterity. METHODS: The initial 75 patients with >/=12 months of functional data who had undergone RALP by a single surgeon were selected. These were compared with 75 patients who had undergone LRP from a confidential database of the same surgeon experienced in LRP toward the end of his experience with this modality (>300 cases). RESULTS: The patients in both groups were similar with respect to age, preoperative prostate-specific antigen level, biopsy Gleason score, pathologic stage, and positive margin rate. Statistically significant differences were noted in favor of RALP vs LRP with regard to operative time (199 vs 232 minutes, P < .001), intraoperative blood loss (230 vs 311 mL, P = .004), and length of stay (1.95 vs 3.4 days, P < .0001). The 12-month continence rate was 89% after LRP and 93.3% after RALP (P = .56). The potency rate was 71.1% and 76.5% at 12 months after LRP and RALP (P = .64) for a bilateral nerve-sparing procedure, respectively. CONCLUSIONS: Our initial experience has revealed that RALP is an equivalent, if not a superior, minimally invasive surgical option for localized prostate cancer with less blood loss and a shorter operative time and length of stay. Although the potency and continence rates were comparable, a trend was noted toward a faster return of functional outcomes in our early RALP experience. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/18952268/Direct_comparison_of_surgical_and_functional_outcomes_of_robotic_assisted_versus_pure_laparoscopic_radical_prostatectomy:_single_surgeon_experience_ DB - PRIME DP - Unbound Medicine ER -