Category: Laparoscopic/ Robotic: Prostate

MP20-6 - Transition from pure laparoscopic radical prostatectomy to robot-assisted laparoscopic prostatectomy is associated with a reduction of positive surgical margin

Sat, Sep 22
2:00 PM - 4:00 PM

Introduction & Objective :

In spite of the increasing use of robot-assisted laparoscopic prostatectomy (RALP) worldwide, it is still controversial whether RALP contributes to oncological outcome. The objective of this study is to compare the surgical outcomes including surgical margin status between RALP and pure laparoscopic radical prostatectomy (LRP).


Methods :

In 863 consecutive patients with localized prostate cancer who underwent LRP (n = 563) or RALP (n = 300) between February 2000 and July 2017 at single institution, were comprised in this study. The demographic data, surgical outcomes, including surgical margin status, and postoperative complications in the two groups were analyzed and compared.


Results :

Preoperative patient data indicated that both groups were comparable in prostate-specific antigen (PSA) levels. However, Gleason score, clinical T stage of the RALP group were significantly higher than those of LRP group, and therefore there are more high-risk patients in the RALP group (38% vs 24%, p43g), and surgical approach (LRP vs RALP) were significantly associated with positive surgical margin. There were no differences in rate of continence between the two groups<./p>


Conclusions :

Robotic assistance offers better results than pure laparoscopy in terms of surgical margins. Distribution of positive surgical margins in RALP group is also different from that in LRP group.

Ken-ichi Tabata

Assistant professor
Department of Urology, Kitasato University School of Medicine
Sagamihara, Kanagawa, Japan

Hideyasu Tsumura

Department of Urology, Kitasato University School of Medicine
Sagamihara, Kanagawa, Japan

Takahiro Hirayama

Clinical Fellow
Department of Urology, Kitasato University School of Medicine
Sagamihara, Kanagawa, Japan

Takahiro HIRAYAMA, MD

Professional Experience
Current
Fellow
Dept. of Urology, Kitasato University Hospital (Sagamihara-city, Kanagawa ,Japan) Apr,2013- present
Previous
Resident
Dept. of Urology, Kitasato University Hospital (Sagamihara-city, Kanagawa, Japan) Oct,2012- Mar.2013
Postdoctoral Fellow
Dept. of Genitourinary, MD Anderson Cancer Center (Houston, TX, USA) Jun,2010- Sep,2012
Resident
Dept. of Urology, Kitasato University Hospital (Sagamihara-city, Kanagawa, Japan) May,2002- Mar,2010

Education and Training
The Japanese Urological Association (Bunkyo-ku,Tokyo,Japan), Board Certified Instructor and Specialist of The Japanese Urological Association
The Japanese Board of Cancer Therapy (Shinjuku-ku,Tokyo,Japan), Board Certified physician of Japanese Board of Cancer Therapy
The Japan Society of Transplantation (Shinjuku-ku,Tokyo,Japan), Board Certified transplant physician by The Japan Society of Transplantation
The Japan Society of Endoscopic surgery (Chiyoda-ku,Tokyo,Japan),Endoscopic surgical skill qualification system: qualified urologist
Kitasato University Graduate School of Medicine (Sagamihara-city, Kanagawa, Japan), Ph.D in Medicine
Kitasato University School of Medicine (Sagamihara-city, Kanagawa ,Japan), M.D.

Daisuke Ishii

Department of Urology, Kitasato University
Sagamihara, Kanagawa, Japan

Kazumasa Matsumoto

Department of Urology, Kitasato University School of Medicine
Sagamihara, Kanagawa, Japan

Masatsugu Iwamura

Professor
Department of Urology, Kitasato University School of Medicine
Sagamihara, Kanagawa, Japan