Comparison of robot assistant radical prostatectomy by transperitoneal versus extraperitoneal approach

Abstract

Objective To compare the safety and oncological results of robot-assisted laparoscopic radical prostatectomy performed between transperitoneal and extraperitoneal approach. Methods 79 patients underwent transperitoneal robot-assisted laparoscopic radical prostatectomy(Tp-RLRP). The other 86 consecutive patients went through extraperitoneal robot-assisted laparoscopic radical prostatectomy(Ep-RLRP). Results All procedures were performed successfully without conversion. Total procedure time for Ep-RLRP was shorter than it for Tp-RLRP[(218.1±54.4) min vs.(180.2±47.1)min, P<0.001]. Docking time for Ep-RLRP was longer than Tp-RLRP[(21.5±7.1)min vs.(19.5±5.7)min, P<0.001]. Blood lost of Tp-RLRP was lesser than Ep-RLRP[(122.4±71.0)ml vs.(140.4±90.7)ml, P<0.05]. There were no significant differences between two groups in terms of bowel function recovery, drainage tube reserve, foley catheter duration, etc. There were 19 patients(24.1%)and 4 patients(4.7%)were suffered lymph leakage in two groups separately, P<0.001. One delayed vesiclurethra hemorrhagic patient and one mesenteric torsion patient were happened in Tp-RLRP group. There were no significant differences between two groups in terms of surgical margin, biochemical recurrence and urine continence. Conclusion Compared to Tp-RLRP, Ep-RLRP can provide similar short-term oncological control, recovery of postoperative urine continence, shorter operation time and lower complication rates. Key words: Robotics; Prostate cancer; Prostatectomy