scholarly journals Latest Comprehensive Medical Resource Consumption in Robot-Assisted versus Laparoscopic and Traditional Open Radical Prostatectomy: A Nationwide Population-Based Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1564
Author(s):  
Szu-Yuan Wu ◽  
Shyh-Chyi Chang ◽  
Chang-I Chen ◽  
Chung-Chien Huang
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Surgical Complications ◽  
Resource Consumption ◽  
Medical Resource ◽  
Robot Assisted ◽  
Monetary Cost ◽  
The Third ◽  
Open Radical Prostatectomy

Background: Few studies have evaluated long-term medical monetary cost in patients with prostate cancer (PC) receiving open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), or robot-assisted radical prostatectomy (RARP). To the best of our knowledge, this is the largest and longest follow-up study to examine medical monetary cost in patients with PC undergoing ORP, LRP, or RARP. After adjustment for confounders, the medical monetary cost in the RARP group was the least compared with that in the ORP and LRP groups. Purpose: To estimate long-term medical resource consumption among patients with prostate cancer (PC) receiving open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), or robot-assisted radical prostatectomy (RARP). Patients and Methods: Participants were men enrolled in the Taiwan Cancer Registry with localized PC diagnosis who received radical prostatectomy. After adjustment for confounders, a generalized linear mixed model was used to determine significant differences in the number of urology outpatient clinic visits required, proportion of patients being hospitalized for urinary diseases or surgical complications, and medical reimbursement for urinary diseases or surgical complications following ORP, LRP, or RARP in the first, second, and third years. Results: No differences were observed in the median number of urology outpatient clinic visits between the three types of surgical modalities up to the second year after ORP, LRP, and RARP (median: 15, 10, and seven visits, respectively; p < 0.001), but significant differences were observed in the third year. Similarly, with RARP (10.9% versus 18.7% in ORP and 9.8% in LRP; p = 0.0014), the rate of hospitalization for urinary diseases or surgical complications decreased in the third year. Medical reimbursement for urinary diseases or surgical complications reduced after RARP compared with that for ORP and LRP, with approximately 22% reduction in the first year (p = 0.0052) and 20–40% reduction in the third year (p value = 0.0024). Conclusions: Medical resource consumption in the RARP group was less compared with those in the ORP and LRP groups.

scholarly journals Predictors of complications occurring after open and robot-assisted prostate cancer surgery: a retrospective evaluation of 1062 consecutive patients treated in a tertiary referral high volume center

2021 ◽  
Author(s):  
Antonio Benito Porcaro ◽  
Alessandro Tafuri ◽  
Riccardo Rizzetto ◽  
Nelia Amigoni ◽  
Marco Sebben ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Postoperative Complications ◽  
Radical Prostatectomy ◽  
Blood Loss ◽  
Open Approach ◽  
Intraoperative Blood Loss ◽  
Tertiary Referral ◽  
Robot Assisted ◽  
The Third ◽  
Major Complications

AbstractTo investigate factors associated with the risk of major complications after radical prostatectomy (RP) by the open (ORP) or robot-assisted (RARP) approach for prostate cancer (PCa) in a tertiary referral center. 1062 consecutive patients submitted to RP were prospectively collected. The following outcomes were addressed: (1) overall postoperative complications: subjects with Clavien-Dindo System (CD) one through five versus cases without any complication; (2) moderate to major postoperative complications: cases with CD < 2 vs.  ≥ 2, and 3) major post-operative complications: subjects with CDS CD ≥  3 vs.  < 3. The association of pre-operative and intra-operative factors with the risk of postoperative complications was assessed by the logistic regression model. Overall, complications occurred in 310 out of 1062 subjects (29.2%). Major complications occurred in 58 cases (5.5%). On multivariate analysis, major complications were predicted by PCa surgery and intraoperative estimated blood loss (EBL). ORP compared to RARP increased the risk of major CD complications from 2.8 to 19.3% (OR = 8283; p < 0.0001). Performing ePLND increased the risk of major complications from 2.4 to 7.4% (OR = 3090; p < 0.0001). Assessing intraoperative blood loss, the risk of major postoperative complications was increased by BL above the third quartile when compared to subjects with intraoperative blood loss up to the third quartile (10.2% vs. 4.6%; OR = 2239; 95%CI: 1233–4064). In the present cohort, radical prostatectomy showed major postoperative complications that were independently predicted by the open approach, extended lymph-node dissection, and excessive intraoperative blood loss.

scholarly journals Robotic-Assisted Laparoscopic Radical Prostatectomy: An Objective Assessment and Review of the Literature

2006 ◽  
Vol 6 ◽  
pp. 2589-2061 ◽  
Author(s):  
Lester S. Borden Jr. ◽  
Paul M. Kozlowski
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Objective Assessment ◽  
Cancer Control ◽  
Laparoscopic Radical Prostatectomy ◽  
Robotic Assisted ◽  
Open Radical Prostatectomy ◽  
Term Data

Robotic-assisted laparoscopic radical prostatectomy (RLRP) has become an accepted treatment option for men with prostate cancer. A search of the available literature through January 2006 was performed to analyze the surgical technique, outcomes data, and other unique issues regarding RLRP. While prospective, randomized trials and long-term data are lacking, short-term data from single institution series have demonstrated outcomes for RLRP that appear to be equivalent to those for open radical prostatectomy (ORP). Although not yet proven, some encouraging data suggest that RLRP may be able to achieve improved cancer control, postoperative urinary control, and erectile function compared to open surgery for prostate cancer. Definite advantages of RLRP over ORP are not yet established. Future studies will determine the role of RLRP in the surgical treatment of men with prostate cancer.

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.

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.

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