Prostatectomie totale laparoscopique standard versus laparoscopique robot-assistée : étude comparative sur les résultats fonctionnels urinaires

Abstract

To compare urinary functional outcomes after LP prostatectomy or robotic assisted laparoscopic prostatectomy performed by a single surgeon regarding to his initial experience. Between March 2005 and April 2007, 247 consecutive patients underwent radical prostatectomy, either by LP approach (125) or by robotic-assisted laparoscopic (RALP) approach (122). The only criteria to chose robot or not, was the Robot Da Vinci's availability. There was no statistical difference between the two groups in terms of preoperative characteristics. The continence rate was 83% in PL group versus 81% in RALP group. More precisely, among men wearing at least one pad, 71% of patients in PL groups wear one pad/day versus 87% of patients in RALP group. Multivariate analysis on continence appears to be in favors of RALP group (Odd Ratio 2.1 [CI: 0,86-5,48]). Incontinence appears to be less severe and frequent in the RALP group. In practice, surgeon's impression of the robot's interest is evident, but more important number of patients and longer follow-up is necessary.