Background:Radical prostatectomy is the gold standard surgical treatment for organ-confined prostate cancer.
There is no consensus on the impact of prior laparoscopic experience on the learning curve of Robot assisted laparoscopic prostatectomy (RALP).
Objective:We compared the perioperative complications and early patient outcomes from our initial 100 cases of RALP with Laparoscopic prostatectomy (LRP) cases performed well beyond the learning curve. Design and participants: Between July 2011 and January 2012, 110 RALP were performed by one of two surgeons, each with a prior experience of over 1000 LRP. The cases were pair matched from among the last 208 patients who had undergone LRP by the same surgeons at the same time.
Outcome Measurements and Statistical Analysis:The clinical parameters, operative details, post operative complications and short term outcomes from these patients, collected prospectively, were compared between the two groups.
Results:The PSA and age of the two groups was similar. The operating time (128.4 vs 153.9 minutes; P=0.01) and blood loss (200 vs 254 ml; P=0.01) was significantly less for the LRP group, but the duration of catheterization was similar (5.89 vs 6.2 days).The complication rate was low. None of the patients required conversions or had a visceral injury or blood transfusion. 23 patients in the LRP group and 33 patients in the RALP group had extraprostatic disease and the positive margin rate was 14% and 19% for these respective groups. At 3 months, PSA was undetectable in 94% of LRP and 92% RALP patients while 56% and 65% (P=0.062) patients in these groups were using 0-2 pads per day.
Conclusions: The initial results of the outcome of RALP are at least at par with those of LRP and to those of previously published RALP series. This suggests the lack of a steep learning curve for experienced laparoscopic surgeons in performing RALP.
Written by:
Stolzenburg JU, Qazi HA, Holze S, Mende M, Nicolaus M, Franz T, Phuc H, Dietel A, Liatsikos EN, Minh D. Are you the author?
University of Leipzig, Urology, Leipzig, Germany.
Reference: J Endourol. 2012 Jul 26. Epub ahead of print.
doi: 10.1089/end.2012.0262
PubMed Abstract
PMID: 22834963
UroToday.com Prostate Cancer Section
