Abstract
BackgroundThe standard surgical treatment of localized prostate cancer (PCa) has been rapidly changed along the last two decades from open to laparoscopic and finally robot-assisted techniques. Herein, we compare the three procedures for radical prostatectomy (RP), namely radical retropubic (RRP), laparoscopic (LRP), and robot-assisted laparoscopic (RALRP) regarding the perioperative clinical outcome and complication rate in four academic institutions.MethodsA total of 394 patients underwent RP between January 2016 and December 2018 in four academic institutions; their records were reviewed. We recorded the patient age, BMI, PSA level, Gleason score and TNM stage, type of surgery, the pathological data from the surgical specimen, the perioperative complications, unplanned reoperating, and readmission rates within 3 months postoperatively. Statistical significance was set at (P < 0.05). All reported P values are two-sided.ResultsA total of 123 patients underwent RALRP, 220 patients underwent RRP, and 51 underwent LRP. There was no statistically significant difference between the three groups regarding age, BMI, prostatic volume, and preoperative PSA. However, there were statistically significant differences between them regarding the operating time (P < .0001), catheterization period (P < .001), hospital stay (P < .0001), and overall complications rate (P = .023).ConclusionsThe minimally invasive procedures (RALRP and LRP) are followed by a significantly lower complication rate. However, the patients’ factors and surgical experience likely impact perioperative outcomes and complications.
Highlights
The standard surgical treatment of localized prostate cancer (PCa) has been rapidly changed along the last two decades from open to laparoscopic and robot-assisted techniques
Several comparative studies done and stated that LRP and robot-assisted laparoscopic (RALRP) are associated with decreased operative blood loss, decreased risk of transfusion, and similar risk of positive surgical margin when compared with RRP [7, 8]
Radical prostatectomy was done under general anesthesia, performed according to the techniques described by Walsh, 1983 either RRP, extraperitoneal LRP, or transperitoneal RALP [9]
Summary
The standard surgical treatment of localized prostate cancer (PCa) has been rapidly changed along the last two decades from open to laparoscopic and robot-assisted techniques. We compare the three procedures for radical prostatectomy (RP), namely radical retropubic (RRP), laparoscopic (LRP), and robot-assisted laparoscopic (RALRP) regarding the perioperative clinical outcome and complication rate in four academic institutions. Radical prostatectomy (RP) is the surgical treatment of prostate cancer (PCa), which has been performed for more than 100 years [1]. The robot offered improved visualization, increased dexterity, restored proper hand–eye coordination, and an Faddan et al Afr J Urol (2020) 26:73 ergonomic position for the surgeon. Despite these wellrecognized benefits, it has profound drawbacks such as the cost of acquiring and maintaining this new technology can be prohibitive [5]. We present our experience with RRP, LRP, and RALRP regarding the perioperative outcomes and complications rates
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