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Robot-assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high-volume laparoscopy reference centre.
BJU Int. 2010 Apr; 105(8):1155-60.BI

Abstract

OBJECTIVE

To describe our current procedure of robot-assisted laparoscopic radical prostatectomy (RALP), and to assess the effect of the learning curve on perioperative data, early oncological outcomes and functional results, as RALP has increasingly become a treatment option for men with localized prostate cancer.

PATIENTS AND METHODS

In all, 206 consecutive men had a RALP between July 2001 and November 2008 for localized prostate cancer. Among the overall cohort, the 175 men operated on by the same surgeon were distributed into five groups according to the chronological order of the procedures. The mean follow-up after RALP was 18.3 months. Patient demographics, surgical data and postoperative variables were collected into a prospective database. Data were compared by chronological groups into single-surgeon cohort.

RESULTS

The median operative time and blood loss were 140 min and 350 mL, respectively. The complication rate was 8.3%. Cancers were pT3-4 in 34.5%. The mean hospital stay and duration of bladder catheterization were 4.3 and 8.2 days, respectively. The rate of positive surgical margins (PSMs) was 17.2% in pT2 cancers. The recovery rate of continence was 98% at 12 months. Intraoperative time, blood loss and length of hospital stay were significantly improved after a short learning curve. The continence recovery, the rate and the length of PSM were also improved beyond the learning curve, but difference was not statistically significant.

CONCLUSIONS

RALP is a safe and reproducible procedure and offers a short learning curve for experienced laparoscopic surgeons. Beyond the learning curve, continued experience might also provide further improvements in terms of operative, pathological and functional results.

Authors+Show Affiliations

INSERM U955 eq07 Department of Urology, APHP, CHU Henri Mondor, Créteil, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19888970

Citation

Ploussard, Guillaume, et al. "Robot-assisted Extraperitoneal Laparoscopic Radical Prostatectomy: Experience in a High-volume Laparoscopy Reference Centre." BJU International, vol. 105, no. 8, 2010, pp. 1155-60.
Ploussard G, Xylinas E, Salomon L, et al. Robot-assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high-volume laparoscopy reference centre. BJU Int. 2010;105(8):1155-60.
Ploussard, G., Xylinas, E., Salomon, L., Vordos, D., Hoznek, A., Abbou, C. C., & De La Taille, A. (2010). Robot-assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high-volume laparoscopy reference centre. BJU International, 105(8), 1155-60. https://doi.org/10.1111/j.1464-410X.2009.09013.x
Ploussard G, et al. Robot-assisted Extraperitoneal Laparoscopic Radical Prostatectomy: Experience in a High-volume Laparoscopy Reference Centre. BJU Int. 2010;105(8):1155-60. PubMed PMID: 19888970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robot-assisted extraperitoneal laparoscopic radical prostatectomy: experience in a high-volume laparoscopy reference centre. AU - Ploussard,Guillaume, AU - Xylinas,Evanguelos, AU - Salomon,Laurent, AU - Vordos,Dimitri, AU - Hoznek,Andras, AU - Abbou,Claude-Clément, AU - De La Taille,Alexandre, Y1 - 2009/11/03/ PY - 2009/11/6/entrez PY - 2009/11/6/pubmed PY - 2012/2/10/medline SP - 1155 EP - 60 JF - BJU international JO - BJU Int VL - 105 IS - 8 N2 - OBJECTIVE: To describe our current procedure of robot-assisted laparoscopic radical prostatectomy (RALP), and to assess the effect of the learning curve on perioperative data, early oncological outcomes and functional results, as RALP has increasingly become a treatment option for men with localized prostate cancer. PATIENTS AND METHODS: In all, 206 consecutive men had a RALP between July 2001 and November 2008 for localized prostate cancer. Among the overall cohort, the 175 men operated on by the same surgeon were distributed into five groups according to the chronological order of the procedures. The mean follow-up after RALP was 18.3 months. Patient demographics, surgical data and postoperative variables were collected into a prospective database. Data were compared by chronological groups into single-surgeon cohort. RESULTS: The median operative time and blood loss were 140 min and 350 mL, respectively. The complication rate was 8.3%. Cancers were pT3-4 in 34.5%. The mean hospital stay and duration of bladder catheterization were 4.3 and 8.2 days, respectively. The rate of positive surgical margins (PSMs) was 17.2% in pT2 cancers. The recovery rate of continence was 98% at 12 months. Intraoperative time, blood loss and length of hospital stay were significantly improved after a short learning curve. The continence recovery, the rate and the length of PSM were also improved beyond the learning curve, but difference was not statistically significant. CONCLUSIONS: RALP is a safe and reproducible procedure and offers a short learning curve for experienced laparoscopic surgeons. Beyond the learning curve, continued experience might also provide further improvements in terms of operative, pathological and functional results. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/19888970/Robot_assisted_extraperitoneal_laparoscopic_radical_prostatectomy:_experience_in_a_high_volume_laparoscopy_reference_centre_ L2 - https://doi.org/10.1111/j.1464-410X.2009.09013.x DB - PRIME DP - Unbound Medicine ER -