Category: Laparoscopic/ Robotic: Prostate
Introduction & Objective : From 2011 to 2016, 169 patients underwent laparoscopic radical prostatectomy (LRP) for a prostatic cancer at our department. And, from 2016 we have performed robotic-assisted laparoscopic prostatectomy (RALP) to 75 patients. We compared the results of initial cases of RALP and LRP in our department.
Methods : Patients’ records from March 2011 to October 2017 were retrospectively reviewed. We compared positive surgical margin rate (PSM rate) and the learning curve of the operative time about initial 75 cases of RALP and initial 75 cases of LRP. We analyzed PSM rate in every site, namely apex, anterior, posterolateral and bladder-neck.
Results : The mean operative time of RALP was 256 minutes, and of LRP was 308 minutes. On the operative time, RALP was significantly a better result than LRP. Total operative time was well correlated with the accumulation of cases on the RALP group (|r| = 0.55, P < 0.001) and the LRP group (|r| = 0.494, P In RALP, the mean operative time was significantly shorter after the 26th case than before the 25th case. In LRP, on the other hand, the mean operative time was significantly shorter after the 51th case than before the 50th case. PSM rate was 29.3% in RALP, and 30.7% in LRP. There was no significant difference of PSM rate. But, PSM rate at the apex aspect of RALP (9.3%) was significantly lower than that of LRP (21.3%) (P = 0.041).
Conclusions : These results suggest that RALP provides certain advantages to LRP in terms of surgical and oncologic outcomes, and learning curve on the operative time. Particularly, RALP is advantageous about the complete dissection of the apex aspect.
Yasushi Miyagawa– Chief Medical Director, Department of Urology, Sumitomo Hospital, Osaka, Osaka, Japan
Makoto Matsushita– , Osaka, Osaka, Japan
Hiroaki Kitakaze– , Osaka, Osaka, Japan
Sohei Kuribayashi– , Osaka, Osaka, Japan
Takuya Okusa– , Osaka, Osaka, Japan
Koichi Okada– subchief, Sumitomo hospital, Osaka, Osaka, Japan
Naoki Mori– , Osaka, Osaka, Japan
Yasuhiro Matsuoka– , Osaka, Osaka, Japan
Toshiaki Yoshioka– , Osaka, Osaka, Japan
Chief Medical Director
Department of Urology, Sumitomo Hospital
Osaka, Osaka, Japan