Laparoscopic/ Robotic: Prostate

Moderated Poster Session

MP15-18 - A comparative study of learning curve and positive surgical margin rate in apex, anterior, posterolateral and bladder-neck in initial cases of robotic and laparoscopic prostatectomy

Saturday, September 22
10:00 AM - 12:00 PM
Location: Room 242B

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

Yasushi Miyagawa, MD., Ph.D
Chief Medical Director, Department of Urology, SUMITOMO HOSPITAL, Osaka, Japan
Title and Award: 1990 M.D. (Japanese Ministry of Health Labor and Welfare)
2002 Ph.D. (Doctor of Medical Science in Osaka University Graduate School of Medicine)
2003 International scholarship in the Department of Urology, Cleveland Clinic Foundation, OH, U.S.A.
Professional training and Employments:
1990-1993 Clinical and Research Resident in Urology, Osaka University Hospita
1993-1996 Visiting Fellow of Molecular Endocrinology and Reproduction Research Branch,
National Institute of Child Health and Human Development (NICHD), National
Institutes of Health (NIH), Bethesda, M.D. U.S.A.
1996-2000 Public Welfare Technical Officer of Osaka National Hospital, Osaka, Japan
2000-2003 Clinical Fellow of Osaka University Hospital, Suita, Osaka, Japan
2003-2009 Assistant Professor, Department of Urology, Osaka University Hospital, Osaka, Japan
2009-2014 Lecturer, Department of Urology, Osaka University Hospital, Osaka, Japan
2014-2017 Associate Professor, Department of Urology, Osaka University Hospital, Osaka, Japan
2017-present Chief Medical Director, Department of Urology, SUMITOMO HOSPITAL, Osaka, Japan

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    Makoto Matsushita

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      Hiroaki Kitakaze

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        Sohei Kuribayashi

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          Takuya Okusa

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            Koichi Okada

            subchief
            Sumitomo hospital

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              Naoki Mori

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                Yasuhiro Matsuoka

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                  Toshiaki Yoshioka

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                    MP15-18 - A comparative study of learning curve and positive surgical margin rate in apex, anterior, posterolateral and bladder-neck in initial cases of robotic and laparoscopic prostatectomy



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