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Laparoscopic versus robotic-assisted radical prostatectomy: an Australian single-surgeon series.
ANZ J Surg. 2015 Mar; 85(3):154-8.AJ

Abstract

BACKGROUND

In Australia, robotic-assisted radical prostatectomy (RARP) has steadily replaced open and laparoscopic surgery in the management of localized prostate cancer. Given the increased cost of this technology, we aimed to compare the perioperative, pathological, oncological and functional outcomes as well as short-term complications of laparoscopic and RARP.

METHODS

We performed a retrospective review of prospectively collected data on 200 consecutive patients during the transition of a single surgeon (DM) from pure laparoscopic (n = 100) to RARP (n = 100) between September 2007 and March 2011.

RESULTS

Median operative time and estimated blood loss were the same for both surgical approaches, 195 min (P = 0.29) and 300 mL (P = 0.88) respectively. Median length of hospital stay was shorter for RARP (P = 0.003). Complication rates were not statistically different between groups. There was no significant difference in positive surgical margin rates in pT2 (P = 0.36) or pT3 disease (0.99) or biochemical recurrence rate between groups (P = 0.14). The 12 months continence rate was improved with RARP compared with laparoscopic radical prostatectomy (93% versus 82%; P = 0.025). The potency rate was 56% and 74% at 12 months after laparoscopic radical prostatectomy and RARP respectively (P = 0.12) for a bilateral nerve sparing procedure.

CONCLUSION

We conclude from our single-surgeon comparative series that the robotic approach results in a significantly shorter length of hospital stay and improved 12 months continence rates and demonstrated a trend towards better potency rates. Complications, positive surgical margin rates and the requirement for adjuvant therapy are all improved with the robotic approach but did not show statistically significant differences.

Authors+Show Affiliations

Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

24730750

Citation

Papachristos, Alexander, et al. "Laparoscopic Versus Robotic-assisted Radical Prostatectomy: an Australian Single-surgeon Series." ANZ Journal of Surgery, vol. 85, no. 3, 2015, pp. 154-8.
Papachristos A, Basto M, Te Marvelde L, et al. Laparoscopic versus robotic-assisted radical prostatectomy: an Australian single-surgeon series. ANZ J Surg. 2015;85(3):154-8.
Papachristos, A., Basto, M., Te Marvelde, L., & Moon, D. (2015). Laparoscopic versus robotic-assisted radical prostatectomy: an Australian single-surgeon series. ANZ Journal of Surgery, 85(3), 154-8. https://doi.org/10.1111/ans.12602
Papachristos A, et al. Laparoscopic Versus Robotic-assisted Radical Prostatectomy: an Australian Single-surgeon Series. ANZ J Surg. 2015;85(3):154-8. PubMed PMID: 24730750.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic versus robotic-assisted radical prostatectomy: an Australian single-surgeon series. AU - Papachristos,Alexander, AU - Basto,Marnique, AU - Te Marvelde,Luc, AU - Moon,Daniel, Y1 - 2014/04/15/ PY - 2014/03/06/accepted PY - 2014/4/16/entrez PY - 2014/4/16/pubmed PY - 2015/12/30/medline KW - laparoscopic radical prostatectomy KW - prostate cancer KW - radical prostatectomy KW - robotic surgery KW - robotic-assisted radical prostatectomy SP - 154 EP - 8 JF - ANZ journal of surgery JO - ANZ J Surg VL - 85 IS - 3 N2 - BACKGROUND: In Australia, robotic-assisted radical prostatectomy (RARP) has steadily replaced open and laparoscopic surgery in the management of localized prostate cancer. Given the increased cost of this technology, we aimed to compare the perioperative, pathological, oncological and functional outcomes as well as short-term complications of laparoscopic and RARP. METHODS: We performed a retrospective review of prospectively collected data on 200 consecutive patients during the transition of a single surgeon (DM) from pure laparoscopic (n = 100) to RARP (n = 100) between September 2007 and March 2011. RESULTS: Median operative time and estimated blood loss were the same for both surgical approaches, 195 min (P = 0.29) and 300 mL (P = 0.88) respectively. Median length of hospital stay was shorter for RARP (P = 0.003). Complication rates were not statistically different between groups. There was no significant difference in positive surgical margin rates in pT2 (P = 0.36) or pT3 disease (0.99) or biochemical recurrence rate between groups (P = 0.14). The 12 months continence rate was improved with RARP compared with laparoscopic radical prostatectomy (93% versus 82%; P = 0.025). The potency rate was 56% and 74% at 12 months after laparoscopic radical prostatectomy and RARP respectively (P = 0.12) for a bilateral nerve sparing procedure. CONCLUSION: We conclude from our single-surgeon comparative series that the robotic approach results in a significantly shorter length of hospital stay and improved 12 months continence rates and demonstrated a trend towards better potency rates. Complications, positive surgical margin rates and the requirement for adjuvant therapy are all improved with the robotic approach but did not show statistically significant differences. SN - 1445-2197 UR - https://www.unboundmedicine.com/medline/citation/24730750/Laparoscopic_versus_robotic_assisted_radical_prostatectomy:_an_Australian_single_surgeon_series_ L2 - https://doi.org/10.1111/ans.12602 DB - PRIME DP - Unbound Medicine ER -