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Radical prostatectomy: initial experience with robot-assisted laparoscopic procedures at a large university hospital.
Scand J Urol. 2014 Jun; 48(3):252-8.SJ

Abstract

OBJECTIVE

The aim of this study was to compare oncological and functional outcomes between robot-assisted laparoscopic radical prostatectomy (RALP) and retropubic radical prostatectomy (RRP) during the initial phase with RALP at a large university hospital.

MATERIAL AND METHODS

Patient and tumour characteristics, surgeon, nerve sparing, surgical margins and blood loss were recorded prospectively in patients who underwent RRP or RALP between April 2008 and May 2012. Patients filled out the Danish Prostate Symptom Score (DAN-PSS) and International Index of Erectile Function 5 (IIEF-5) questionnaires before surgery and at follow-up and they were asked to report their use of pads/diapers. Potency was defined as an IIEF-5 score of at least 17 with or without phosphodiesterase-5 inhibitors. Patients using up to one pad daily for security reasons only were considered continent. Positive surgical margins, blood loss and functional outcomes were compared between groups.

RESULTS

Overall, 453 patients were treated with RRP and 585 with RALP. On multivariate logistic regression analyses, the type of surgery did not affect surgical margins (p = 0.96) or potency at 12 months (p = 0.7). Patients who had undergone RRP had an increased chance of reporting subjective continence at 12 months (odds ratio 2.6, p = 0.014). There was no difference in the proportion of RRP and RALP patients who underwent surgical treatment for incontinence (p = 0.57). On multivariate linear regression analysis, RALP was an independent predictor of a low perioperative blood loss (RRP:RALP ratio = 2.89, p < 0.0001).

CONCLUSIONS

RALP is a safe procedure with regard to perioperative and oncological results. However, it is important to be aware that functional outcomes may be compromised in the initial phase when introducing RALP.

Authors+Show Affiliations

Department of Urology, Herlev Hospital , Herlev , Denmark.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24341725

Citation

Fode, Mikkel, et al. "Radical Prostatectomy: Initial Experience With Robot-assisted Laparoscopic Procedures at a Large University Hospital." Scandinavian Journal of Urology, vol. 48, no. 3, 2014, pp. 252-8.
Fode M, Sønksen J, Jakobsen H. Radical prostatectomy: initial experience with robot-assisted laparoscopic procedures at a large university hospital. Scand J Urol. 2014;48(3):252-8.
Fode, M., Sønksen, J., & Jakobsen, H. (2014). Radical prostatectomy: initial experience with robot-assisted laparoscopic procedures at a large university hospital. Scandinavian Journal of Urology, 48(3), 252-8. https://doi.org/10.3109/21681805.2013.868514
Fode M, Sønksen J, Jakobsen H. Radical Prostatectomy: Initial Experience With Robot-assisted Laparoscopic Procedures at a Large University Hospital. Scand J Urol. 2014;48(3):252-8. PubMed PMID: 24341725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radical prostatectomy: initial experience with robot-assisted laparoscopic procedures at a large university hospital. AU - Fode,Mikkel, AU - Sønksen,Jens, AU - Jakobsen,Henrik, Y1 - 2013/12/17/ PY - 2013/12/18/entrez PY - 2013/12/18/pubmed PY - 2015/1/6/medline KW - erectile dysfunction KW - incontinence KW - prostatectomy KW - prostatic neoplasm KW - robotic instrumentation SP - 252 EP - 8 JF - Scandinavian journal of urology JO - Scand J Urol VL - 48 IS - 3 N2 - OBJECTIVE: The aim of this study was to compare oncological and functional outcomes between robot-assisted laparoscopic radical prostatectomy (RALP) and retropubic radical prostatectomy (RRP) during the initial phase with RALP at a large university hospital. MATERIAL AND METHODS: Patient and tumour characteristics, surgeon, nerve sparing, surgical margins and blood loss were recorded prospectively in patients who underwent RRP or RALP between April 2008 and May 2012. Patients filled out the Danish Prostate Symptom Score (DAN-PSS) and International Index of Erectile Function 5 (IIEF-5) questionnaires before surgery and at follow-up and they were asked to report their use of pads/diapers. Potency was defined as an IIEF-5 score of at least 17 with or without phosphodiesterase-5 inhibitors. Patients using up to one pad daily for security reasons only were considered continent. Positive surgical margins, blood loss and functional outcomes were compared between groups. RESULTS: Overall, 453 patients were treated with RRP and 585 with RALP. On multivariate logistic regression analyses, the type of surgery did not affect surgical margins (p = 0.96) or potency at 12 months (p = 0.7). Patients who had undergone RRP had an increased chance of reporting subjective continence at 12 months (odds ratio 2.6, p = 0.014). There was no difference in the proportion of RRP and RALP patients who underwent surgical treatment for incontinence (p = 0.57). On multivariate linear regression analysis, RALP was an independent predictor of a low perioperative blood loss (RRP:RALP ratio = 2.89, p < 0.0001). CONCLUSIONS: RALP is a safe procedure with regard to perioperative and oncological results. However, it is important to be aware that functional outcomes may be compromised in the initial phase when introducing RALP. SN - 2168-1813 UR - https://www.unboundmedicine.com/medline/citation/24341725/Radical_prostatectomy:_initial_experience_with_robot_assisted_laparoscopic_procedures_at_a_large_university_hospital_ L2 - http://www.tandfonline.com/doi/full/10.3109/21681805.2013.868514 DB - PRIME DP - Unbound Medicine ER -