Abstract
Objective:In this study, we aimed to make a comprehensive comparison of the first hundred robot-assisted radical prostatectomy (RARP) and open retropubic radical prostatectomy (RRP) cases of a single surgeon in a high-volume center.Methods:Preoperative, perioperative and postoperative data were collected retrospectively. Perioperative, oncological data and functional results in the first year were compared between the two groups. There were 204 RARPs between January 1, 2014 and December 31, 2019, and 755 RRPs between April 1, 2007 and December 31, 2019.Results:While the operation time was in favor of the open group (117 vs 188 min, p<0.001), the estimated blood loss (328 vs 150 ml, p<0.001), blood transfusion rate (12 vs 2, p=0.021), and re-operation rate (6 vs 0, p=0.001) were in favor of the robotic group. Mean length of hospital stay (5.4 vs 3.1, p<0.001), urine leak rate (11 vs 2, p=0.033), complication rate (37 vs 16, p=0.018), and the 12th month continence rate (67 vs 85, p=0.002) were better in the robotic group.Conclusions:RARP may provide better perioperative outcomes and lower complication rates after the surgeon factor is eliminated in the early period. Since our case group includes the initial 100 patients, studies with larger patient groups with longer follow-up are needed to adapt these early results to general outcomes.
Highlights
Radical prostatectomy is the main recommended surgical treatment for clinical localized prostate cancer, which provides long-term oncological control
While the operation time was in favor of the open group, all other perioperative data were in favor of the robotic group
Due to its marketing strategy and convenience to the surgeons, robot-assisted radical prostatectomy (RARP) has begun to be applied with increasing frequency, but a significant number of patients are still treated with retropubic radical prostatectomy (RRP) in many countries due to cost constraints.[15]
Summary
Radical prostatectomy is the main recommended surgical treatment for clinical localized prostate cancer, which provides long-term oncological control. Open retropubic radical prostatectomy (RRP) is a conventional surgical method that provides excellent success rates. Pak J Med Sci January - February 2021 Vol 37 No 1 www.pjms.org.pk 167 of this technique. To overcome these difficulties, robot-assisted radical prostatectomy (RARP) technique has been used since the early 2000s. Robot-assisted radical prostatectomy (RARP) technique has been used since the early 2000s It was first used in Germany in 2001 refined by Menon et al in United States.[2,3] Due to the enlarged view and advanced articulation arms of robots, it is predicted that it provides more careful prostate resection and better functional results by preserving the neurovascular bundle
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