We compared perioperative outcomes and costs between open and laparoscopic radical prostatectomy for prostate cancer.
The Japanese Diagnosis Procedure Combination database, including cases from 2007 to 2010, was used by one-to-one propensity-score matching. The following items were compared: complication rate; homologous and autologous transfusion rate; first cystography day and cystography repeat rate; anesthesia time; postoperative length of stay; and costs. Multivariate analyses were carried out by including age, Charlson Comorbidity Index, T stage, hospital volume and hospital academic status as variables. As a result, among 15 616 open and 1997 laparoscopic radical prostatectomies, 1627 propensity-score matched pairs were generated. The laparoscopic approach showed a better overall complication rate (3.4% vs 5.0%), homologous transfusion rate (3.3% vs 9.2%), autologous transfusion rate (44.9% vs 79.3%), first cystography day (mean 6th vs 7th day), mean postoperative length of stay (mean 11 vs 13 days), and cost without surgery and anesthesia (mean $7965 vs $9235; all P < 0.001). Anesthesia time was longer (mean 345 vs 285 min) and total cost was higher (mean $14 980 vs $12 356) for the laparoscopic approach (both P < 0.001). The secondary cystography rates were comparable between the groups (18.3% vs 15.7%, P = 0.144). The multivariate analyses showed similar trends. In conclusion, these findings confirm several benefits of laparoscopy over open approach for radical prostatectomy.
Written by:
Sugihara T, Yasunaga H, Horiguchi H, Tsuru N, Ihara H, Fujimura T, Nishimatsu H, Ohe K, Fushimi K, Homma Y. Are you the author?
Department of Urology, Shintoshi Hospital, Iwata; Department of Urology, The University of Tokyo, Tokyo, Japan.
Reference: Int J Urol. 2013 Jan 16. Epub ahead of print.
doi: 10.1111/iju.12079
PubMed Abstract
PMID: 23320826
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