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Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy: A prospective single surgeon randomized comparative study.
Int J Urol. 2015 Oct; 22(10):916-21.IJ

Abstract

OBJECTIVES

To compare operative, pathological, and functional results of transperitoneal and extraperitoneal robot-assisted laparoscopic radical prostatectomy carried out by a single surgeon.

METHODS

After having experience with 32 transperitoneal laparoscopic radical prostatectomies, 317 extraperitoneal laparoscopic radical prostatectomies, 30 transperitoneal robot-assisted laparoscopic radical prostatectomies and 10 extraperitoneal robot-assisted laparoscopic radical prostatectomies, 120 patients with prostate cancer were enrolled in this prospective randomized study and underwent either transperitoneal or extraperitoneal robot-assisted laparoscopic radical prostatectomy. The main outcome parameters between the two study groups were compared.

RESULTS

No significant difference was found for age, body mass index, preoperative prostate-specific antigen, clinical and pathological stage, Gleason score on biopsy and prostatectomy specimen, tumor volume, positive surgical margin, and lymph node status. Transperitoneal robot-assisted laparoscopic radical prostatectomy had shorter trocar insertion time (16.0 vs 25.9 min for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, P < 0.001), whereas extraperitoneal robot-assisted laparoscopic radical prostatectomy had shorter console time (101.5 vs 118.3 min, respectively, P < 0.001). Total operation time and total anesthesia time were found to be shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy, without statistical significance (200.9 vs 193.2 min; 221.8 vs 213.3 min, respectively). Estimated blood loss was found to be lower for extraperitoneal robot-assisted laparoscopic radical prostatectomy (P = 0.001). Catheterization and hospitalization times were observed to be shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy (7.3 vs 5.8 days and 3.1 vs 2.3 days for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, respectively, P < 0.05). The time to oral diet was significantly shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy (32.3 vs 20.1 h, P = 0.031). Functional outcomes (continence and erection) and complication rates were similar in both groups.

CONCLUSIONS

Extraperitoneal robot-assisted laparoscopic radical prostatectomy seems to be a good alternative to transperitoneal robot-assisted laparoscopic radical prostatectomy with similar operative, pathological and functional results. As the surgical field remains away from the bowel, postoperative return to normal diet and early discharge can be favored.

Authors+Show Affiliations

Department of Urology, School of Medicine, Selcuk University, Konya, Turkey.Departments of Urology and Minimally Invasive & Robotic Surgery, Memorial Atasehir Hospital, Istanbul, Turkey.Departments of Urology and Minimally Invasive & Robotic Surgery, Memorial Atasehir Hospital, Istanbul, Turkey.Department of Urology, Memorial Antalya Hospital, Antalya, Turkey.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26212891

Citation

Akand, Murat, et al. "Transperitoneal Versus Extraperitoneal Robot-assisted Laparoscopic Radical Prostatectomy: a Prospective Single Surgeon Randomized Comparative Study." International Journal of Urology : Official Journal of the Japanese Urological Association, vol. 22, no. 10, 2015, pp. 916-21.
Akand M, Erdogru T, Avci E, et al. Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy: A prospective single surgeon randomized comparative study. Int J Urol. 2015;22(10):916-21.
Akand, M., Erdogru, T., Avci, E., & Ates, M. (2015). Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy: A prospective single surgeon randomized comparative study. International Journal of Urology : Official Journal of the Japanese Urological Association, 22(10), 916-21. https://doi.org/10.1111/iju.12854
Akand M, et al. Transperitoneal Versus Extraperitoneal Robot-assisted Laparoscopic Radical Prostatectomy: a Prospective Single Surgeon Randomized Comparative Study. Int J Urol. 2015;22(10):916-21. PubMed PMID: 26212891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy: A prospective single surgeon randomized comparative study. AU - Akand,Murat, AU - Erdogru,Tibet, AU - Avci,Egemen, AU - Ates,Mutlu, Y1 - 2015/07/26/ PY - 2014/12/19/received PY - 2015/06/02/accepted PY - 2015/7/28/entrez PY - 2015/7/28/pubmed PY - 2016/7/13/medline KW - extraperitoneal KW - prostate cancer KW - radical prostatectomy KW - robot-assisted laparoscopic radical prostatectomy KW - robotic surgery KW - transperitoneal SP - 916 EP - 21 JF - International journal of urology : official journal of the Japanese Urological Association JO - Int J Urol VL - 22 IS - 10 N2 - OBJECTIVES: To compare operative, pathological, and functional results of transperitoneal and extraperitoneal robot-assisted laparoscopic radical prostatectomy carried out by a single surgeon. METHODS: After having experience with 32 transperitoneal laparoscopic radical prostatectomies, 317 extraperitoneal laparoscopic radical prostatectomies, 30 transperitoneal robot-assisted laparoscopic radical prostatectomies and 10 extraperitoneal robot-assisted laparoscopic radical prostatectomies, 120 patients with prostate cancer were enrolled in this prospective randomized study and underwent either transperitoneal or extraperitoneal robot-assisted laparoscopic radical prostatectomy. The main outcome parameters between the two study groups were compared. RESULTS: No significant difference was found for age, body mass index, preoperative prostate-specific antigen, clinical and pathological stage, Gleason score on biopsy and prostatectomy specimen, tumor volume, positive surgical margin, and lymph node status. Transperitoneal robot-assisted laparoscopic radical prostatectomy had shorter trocar insertion time (16.0 vs 25.9 min for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, P < 0.001), whereas extraperitoneal robot-assisted laparoscopic radical prostatectomy had shorter console time (101.5 vs 118.3 min, respectively, P < 0.001). Total operation time and total anesthesia time were found to be shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy, without statistical significance (200.9 vs 193.2 min; 221.8 vs 213.3 min, respectively). Estimated blood loss was found to be lower for extraperitoneal robot-assisted laparoscopic radical prostatectomy (P = 0.001). Catheterization and hospitalization times were observed to be shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy (7.3 vs 5.8 days and 3.1 vs 2.3 days for transperitoneal robot-assisted laparoscopic radical prostatectomy and extraperitoneal robot-assisted laparoscopic radical prostatectomy, respectively, P < 0.05). The time to oral diet was significantly shorter in extraperitoneal robot-assisted laparoscopic radical prostatectomy (32.3 vs 20.1 h, P = 0.031). Functional outcomes (continence and erection) and complication rates were similar in both groups. CONCLUSIONS: Extraperitoneal robot-assisted laparoscopic radical prostatectomy seems to be a good alternative to transperitoneal robot-assisted laparoscopic radical prostatectomy with similar operative, pathological and functional results. As the surgical field remains away from the bowel, postoperative return to normal diet and early discharge can be favored. SN - 1442-2042 UR - https://www.unboundmedicine.com/medline/citation/26212891/Transperitoneal_versus_extraperitoneal_robot_assisted_laparoscopic_radical_prostatectomy:_A_prospective_single_surgeon_randomized_comparative_study_ L2 - https://doi.org/10.1111/iju.12854 DB - PRIME DP - Unbound Medicine ER -