A comparison of perioperative outcome between robot-assisted and laparoscopic radical prostatectomy: experience of a single institution

Vol. 45 (x): 2019 February 1.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0367


Feng Qi 1, Shangqian Wang 1, Haoxiang Xu 1, Yiren Gao 1, Gong Cheng 1, Lixin Hua 1
1 Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China


Purpose: To compare perioperative and pathological results in different approaches of robotic or laparoscopic radical prostatectomy.
Materials and Methods: We retrospectively reviewed 206 patients diagnosed with pros¬tate cancer (PC) from June 2016 to October 2017 in the First Affiliated Hospital of Nan¬jing Medical University. A total of 132 cases underwent robot-assisted laparoscopic radical prostatectomy (RLRP) including 54 patients on transperitoneal robot-assisted laparoscopic radical prostatectomy (Tp-RLRP) and 78 on extraperitoneal robot-assisted laparoscopic radical prostatectomy (Ep-RLRP). Meanwhile, 74 patients performed with extraperitoneal laparoscopic radical prostatectomy (Ep-LPR) were also included. Peri¬operative and pathological data were compared among these groups.
Results: All operations were completed without conversion. There was no signifi¬cant difference in basic and pathological characteristics of patients between each two groups.
In Tp-RLRP vs. Ep-RLRP: Significant differences were found in the comparison in to¬tal operation time [235.98 ± 59.16 vs. 180.45 ± 50.27 min, P = 0.00], estimated blood loss (EBL) [399.07 ± 519.57 vs. 254.49 ± 308.05 mL, P = 0.0473], postoperative pelvic drainage time [5.37 ± 2.33 vs. 4.24 ± 3.08 d, P = 0.0237] and postoperative length of stay [8.15 ± 3.30 vs. 6.49 ± 3.49 d, P = 0.0068] while no significant differences were detected in other variables.
In Ep-RLRP vs. Ep-LPR: Longer total operation time was observed in Ep-RLRP when compared to Ep-LPR [180.45 ± 50.27 vs. 143.80 ± 33.13 min, P = 0.000]. No significant differences were observed in other variables.
Conclusion: In RLRP, Ep-RLRP was proved a safe and effective approach based on the perioperative results compared to Tp-RLRP. Ep-RLRP and Ep-LPR provides equivalent perioperative and pathological outcomes.

Keywords: Robotics; Laparoscopy; Prostatic Neoplasms

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