Comparative Analysis of Results Between Robot-Assisted and Open Radical Prostatectomy

2019 ◽  
Vol 12 (2) ◽  
pp. 157-161
Author(s):  
Nikolay Kolev
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Functional Outcome ◽  
Erectile Function ◽  
Functional Outcomes ◽  
Operating Time ◽  
Robot Assisted ◽  
Open Radical Prostatectomy ◽  
Retropubic Radical Prostatectomy

Summary We aimed to compare results between patients with early- stage prostate cancer who underwent robot-assisted and open radical prostatectomy. We examined preoperative and postoperative data, early and late complications, and analysed oncological and functional outcomes (continence and erectile function) during follow-up. We studied the data of 123 patients with localized prostate cancer, operated with nerve-sparing retropubic radical prostatectomy, divided into two groups. Group 1 included 70 patients who underwent robot-assisted radical prostatectomy (RARP). Group 2 included 53 patients, on whom open retropubic radical prostatectomy (RRP) was performed. We compared preoperative data, complications rate, oncological, and functional outcome (continence and erectile function) during the follow-up period. Operative time was significantly lower in the RRP group. Blood loss and earlier removal of the urinary catheter were significantly lower in the RARP group. The percentage of significant postoperative complications (Clavien-Dindo III-IV) was 0% in the first group and 3% in the second group. During follow-up, the improvement in the functional outcome - continence and erectile function was significantly better in the robot-assisted surgery patients. There were statistically significant better functional outcomes in patients operated on using the robot-assisted technique. The operating time was shorter in the classic radical prostatectomy. The application of robot-assisted radical prostatectomy may help achieve earlier recovery, as compared to open radical prostatectomy.

scholarly journals Original Article. Open Retropubic and Robot-Assisted Radical Prostatectomy in Prostate Carcinoma: Advantages of Methods

2016 ◽  
Vol 9 (2) ◽  
pp. 145-148
Author(s):  
Nikolay H. Kolev ◽  
Jitian A. Atanasov ◽  
Vladislav R. Dunev ◽  
Boyan A. Stoykov ◽  
Rumen P. Kotsev ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Operative Time ◽  
Functional Results ◽  
University Hospital ◽  
Robot Assisted ◽  
Retropubic Radical Prostatectomy ◽  
The University ◽  
Urology Clinic

Summary Prostate cancer (PC) is the most common type of cancer in men inanumber of countries. The choice of surgical technique for radical prostatectomy (RP) concerns both patients and urologists. The choice is not easy to make, since data is still limited due to the lack of large multicentric randomized research trials. For three years (2011-2014), 244 patients with limited prostate cancer were operated in the Urology Clinic of the University Hospital in Pleven. Robot-assisted radical prostatectomy (RARP) was performed on 35 patients (14%), open retropubic radical prostatectomy (ORP) - on 199 patients (81%), and laparoscopic RP - on 12 patients (5%). The preoperative and post-op results from the first two groups were compared. For the follow-up period of 12 months, functional results in 82 patients of the ORPgroup were compared to the results in the 35 patients of the RARPgroup. The operative time was significantly longer in the RARPgroup, and blood loss was lower. The catheter stay was shorter in patients with RARP. The percentage of significant postoperative complications was 0%in the patients with RARPand 3%in the patients with an ORP. RARPpatients demonstrated better continence: 91%vs. 87%and erectile function46%vs.40%at 12 months.

scholarly journals Robotic radical prostatectomy in the 21 st century: evolution of experience

2021 ◽  
Vol 9 (5) ◽  
Author(s):  
Jesus Moreno Sierra
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Functional Outcomes ◽  
Surgical Techniques ◽  
Current Evidence ◽  
Perioperative Outcomes ◽  
Robot Assisted ◽  
Keywords Prostate Cancer ◽  
Novel Technologies ◽  
Open Radical Prostatectomy

The advent of novel technologies and surgical techniques has revolutionized urological surgery in recent years. Robot-assisted radical prostatectomy (RARP) has become the most widely used surgical approach for radical prostatectomy (RP) in the treatment of localized prostate cancer. However, the current available evidence on the benefit of RARP compared to open radical prostatectomy (ORP) is still under debate. Moreover, recent studies have proposed technical modifications of RARP to improve functional outcomes and postoperative quality of life of prostate cancer patients. The aim of this review was to summarize the current evidence on oncological, functional and perioperative outcomes of RARP, considering the results of our series of 408 RARP performed between October 2006 and February 2015 at Clínico San Carlos Hospital, and to provide a framework on the latest and most relevant updates on RARP surgical technique modifications. Keywords Prostate cancer; robot-assisted radical prostatectomy; oncological outcomes; functional outcomes; robotic surgical techniques.

scholarly journals Transvesical Versus Posterior Approach to Retzius-Sparing Robot-Assisted Radical Prostatectomy: A Retrospective Comparison With a 12-Month Follow-Up

2021 ◽  
Vol 11 ◽  
Author(s):  
Wen Deng ◽  
Cheng Zhang ◽  
Hao Jiang ◽  
Yulei Li ◽  
Ke Zhu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Localized Prostate Cancer ◽  
Robot Assisted ◽  
Open Conversion ◽  
Estimated Blood Loss ◽  
Before And After ◽  
Grade Ii

ObjectivesTo assess the perioperative, functional, and oncological outcomes of transvesical robot-assisted radical prostatectomy (T-RARP) and posterior robot-assisted radical prostatectomy (P-RARP) for localized prostate cancer.Materials and MethodsWe analyzed the data of 96 patients who underwent T-RARP or P-RARP for localized prostate cancer between January 2017 and June 2019 in a retrospective fashion.ResultsNo significant differences in the baseline characteristics existed between the T-RARP and P-RARP arms. Both interventions were successfully performed without open conversion in either group. T-RARP was associated with a slightly more operative time (135.3 vs. 127.3 min) and estimated blood loss (105.2 vs. 94.2 mL) than P-RARP, but the differences were not significant (both p > 0.05). The likelihood of transfusion, ≤Grade II, and >Grade II postoperative complications, pT3a disease and positive surgical margins in the T-RARP group was comparable with that in the P-RARP group. No significant differences were noted between these two arms in terms of UC at the removal of catheter and nocturia (p = 0.750 and p = 0.684, respectively), and all included patients recovered UC at 3 months postoperatively. The median International Index of Erectile Function-5 score in both groups remains comparable before and after RARP. The patients in the T-RARP and P-RARP groups had a similar biochemical recurrence-free survival (p = 0.387).ConclusionsBoth T-RARP and P-RARP by experienced hands are feasible for well-selected patients with prostate cancer, obtaining similar outcomes in terms of perioperative results, UC and erectile function, and oncological control within short-term follow-up.

scholarly journals Complications following robot-assisted radical prostatectomy in a prospective Canadian cohort of 305 consecutive cases

2013 ◽  
Vol 7 (3-4) ◽  
pp. 116-21 ◽  
Author(s):  
Andrew Fuller ◽  
Stephen E. Pautler
Keyword(s):  
Radical Prostatectomy ◽  
Major Complication ◽  
Robot Assisted ◽  
Pharmacological Management ◽  
Surgical Technology ◽  
Related Information ◽  
Open Radical Prostatectomy ◽  
Institutional Ethics ◽  
Patient Consent

Background: Robot-assisted radical prostatectomy (RARP) has emerged in the last decade as an alternative to open radical prostatectomy for men with localized prostate cancer. The increased cost of this technique has been justified by its ability to reduce blood loss, and to provide improved vision, less postoperative pain and more rapid recovery from surgery, while maintaining satisfactory oncological and functional outcomes. Given the increasing diffusion of robotic surgical technology within Canada and its associated high capital and operating costs, we review the clinical outcomes and complications from 305 consecutive cases performed at our Canadian institution.Methods: A consecutive cohort of 305 patients with a mean follow up of 30 months was analyzed with institutional ethics approval. All patients were treated and reviewed postoperatively by a single surgeon (SP). The primary aim of the study was to assess the incidence and type of complications associated with RARP in a Canadian setting. Our prospective database captured preoperative, intra-operative and postoperative data and was maintained by an individual independent of the robotic program. We report complications categorized according to the Clavien system. Multiple complications seen in an individual were recorded separately for the purposes of our analysis.Results: Between April 2005 and October 2010, 305 patients underwent RARP at our institution. A total of 70 complications were identified, with 47 (67.1%) requiring only conservative or pharmacological management (Clavien I-II). Twenty-three patients were found to have a major complication (Clavien III-V). Of the 16 who required intervention under general anesthesia, 3 required emergency treatment and the remaining patients underwent elective surgery.Conclusions: RARP has been incorporated at our institution with an acceptably low rate of intra-operative and postoperative complications. We have found that the database was effective in providing patients with outcome-related information, which in turn helped us gain patient consent with regard to the institution-specific risks of RARP.

scholarly journals Salvage robot-assisted radical prostatectomy (sRARP) for radiation resistant prostate cancer in a group of initially high risk patients

2017 ◽  
Vol 1 (1) ◽  
pp. 21-27
Author(s):  
Nirmal Lamichhane ◽  
Adam S. Dowrick ◽  
Ulrika Axcrona ◽  
Bjørn Brennhovd ◽  
Sophie D. Fosså ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
High Frequency ◽  
Salvage Treatment ◽  
Rectal Injury ◽  
Robot Assisted ◽  
Radiation Resistant ◽  
Risk Patients

Introduction: Salvage robot-assisted radical prostatectomy (sRARP) is seen as an attractive option for salvage treatment of radiation therapy -recurrent prostate cancer (PC), thanks in part to the good visualisation that is possible using this modality. However, the results of fewer than 200 salvage sRARPs have been published in the literature. We report the outcomes in a cohort of initially high risk patients of robot-assisted radical prostatectomy as salvage local therapy for radiation-resistant PC in a Scandinavian healthcare setting. Materials and methods: A retrospective review of the charts of all patients who underwent sRARP for biochemical failure (BCF) after primary radiation treatment for localised PC at a single institution was performed. Results: Twenty-two patients, median age 67 years (range 57 to 72), had sRARP performed between June 2008 to July 2013. A median follow-up of 26 months (range 2 to 63) was observed. Perioperative complications occurred in 4 patients (18%), with one patient sustaining a rectal injury. Histo-pathological diagnosis was pT2 in three, pT3a in five, pT3b in twelve and pTx in one patient. Ten patients (45%) had a positive surgical margin (PSM). At follow-up, 54 % of patients were free of biochemical progression and 41% were continent. Conclusions: We showed that salvage RARP is technically feasible in a cohourt of patients with predominantly high risk disease. This study adds to the limited data already in the literature, demonstrating the high frequency of locally advanced (pT3b) PC, a patient group that is usually not included in salvage treatments, as e.g. high frequency ultrasound or salvage brachytherapy. Further, given that the historical barriers to salvage RP with higher rates of rectal injury and poor urinary control no longer seem to be applicable in the modern era, we think that more patients should be considered candidates for this potentially curative salvage treatment of radiation-resistant PC. However, long-term follow-up is needed to confirm if the additional burden on these patients confers to oncological control following the procedure.

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