Laparoscopy and RoboticsExperienced Open vs Early Robotic-assisted Laparoscopic Radical Prostatectomy: A 10-year Prospective and Retrospective Comparison
Section snippets
Materials and Methods
All patients who underwent ORP or RALP procedures in 2004 at our clinical center were included. A single surgeon performed all of the ORP procedures included in this study. A different, single surgeon performed all of the RALP procedures. All patients had clinically localized disease and a life expectancy of ≥10 years. The surgical modality was selected by the patient after being counseled regarding both options. Urologic follow-up was scheduled at 1-2 weeks, then every 3 months for the first
Patient Demographics
A total of 179 patients underwent either ORP or RALP in 2004. Of these patients, 63 (35.2%) and 116 (64.8%) underwent ORP or RALP, respectively. There were no conversions from RALP to ORP. Maximal follow-up time for ORP patients was 10.3 years (interquartile range: 9.7-10.7), which was not significantly different to RALP patients (10.1 years [interquartile range: 9.6-10.5]; P = .191; Table 1). When patients who died during the study period (2004-2014) were taken into account, maximal follow-up
Discussion
Over the last decade, RALP has become more commonplace in the United States.20 Previously reported outcome studies indicate RALP patients experience less surgical blood loss, fewer blood transfusions, shorter length of hospital stay, and improved surgical margin status compared with ORP patients.6, 11, 12, 21 However, less is established regarding comparative longer-term outcomes of ORP and RALP.
Comparable recurrence rates and recurrence-free survival between RALP and ORP patients at 5-year
Conclusion
Oncologic outcome, urinary and sexual function, and mortality are comparable between ORP and RALP patients over an extended follow-up period. Our data support conclusions drawn from previous shorter-term outcome studies and endorse the equanimity between RALP and ORP.
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Cited by (19)
Minimally Invasive Techniques in Urology
2019, Surgical Oncology Clinics of North AmericaCitation Excerpt :Postoperative pain seems comparable between robotic and open cohorts, likely due to the relatively less painful infraumbilical incision for the open procedure.17,18 Older data suggested an equivalent postoperative length of stay; however, more recent data suggest a shorter length of stay with RALP.19–21 The risk of urinary incontinence and erectile dysfunction after prostatectomy remains a concern, regardless of technique.
Patient-reported outcomes after treatment for clinically localized prostate cancer: A systematic review and meta-analysis
2018, Cancer Treatment ReviewsCitation Excerpt :After screening titles and abstracts, 504 were reviewed in full text and 311 were excluded. Of the 193 articles that met the inclusion criteria, 92 were included in the meta-analyses [8,17–107], and 101 articles (88 studies) were not [108–210]. Of the latter, 63 studies because they did not provide the necessary data (mean, SD, and/or number of patients), 21 studies for providing isolated estimators which did not allow to construct a meta-analysis, and 4 studies due to lack of result stratification by treatment.
ProtecTing Low-Risk Prostate Cancer
2017, International Journal of Radiation Oncology Biology PhysicsDisparities in hospitalization outcomes among African-American and White prostate cancer patients
2017, Cancer EpidemiologyCitation Excerpt :We used specific ICD-9 codes for surgical treatments in prostate cancer patients and excluded Benign Prostatic Hyperplasia. We did not differentiate between the robot-assisted prostatectomy and radical prostatectomy in the current study while considering surgical treatment [46,47]. We examined three healthcare outcome events for this analysiss: 1) Hospital length of stay which captures the number of days spent in the hospital, with same day discharges assigned a value of 0; 2) Post-operative complications that includes shock, puncture wounds, disruption of operative wounds, traumatic injury during operation, infections, foreign body left inside body, non-healing wounds and other unspecified complications; and 3) In-hopital mortality.
Focal therapy in prostate cancer: A review of seven common controversies
2016, Cancer Treatment ReviewsCitation Excerpt :Of course, the discerning eye will have noticed that these studies report on radical prostatectomy rather than purely RALP. However, purely in terms of functional outcomes, the evidence that RALP bears advantages over open prostatectomy is wanting [60,61,53]. A systematic review by Finkelstein et al. in 2010 found no convincing evidence that RALP offered a functional outcome advantage over open prostatectomy [60].
Editorial Comment
2016, Urology
Financial Disclosure: The authors declare that they have no relevant financial interests.