Comparison of Continence Recovery Between Robot-Assisted Laparoscopic Prostatectomy and Open Radical Retropubic Prostatectomy: A Single Surgeon Experience

Objectives: Despite the wide diffusion of minimally invasive approaches, such as laparoscopic (LRP) and robot-assisted radical prostatectomy (RALP), few studies compare the results of these techniques with the retropubic radical prostatectomy (RRP) approach. The aim of this study is to compare the surgical, functional, and oncological outcomes and cost-effectiveness of RRP, LRP, and RALP. Methods: A systematic review of the literature was performed in the PubMed and Embase databases in December 2013. A ‘free-text' protocol using the term ‘radical prostatectomy' was applied. A total of 16,085 records were found. The authors reviewed the records to identify comparative studies to include in the review. Results: 44 comparative studies were identified. With regard to the perioperative outcome, LRP and RALP were more time-consuming than RRP, but blood loss, transfusion rates, catheterisation time, hospitalisation duration, and complication rates were the most optimal in the laparoscopic approaches. With regard to the functional and oncological results, RALP was found to have the best outcomes. Conclusion: Our study confirmed the well-known perioperative advantage of minimally invasive techniques; however, available data were not sufficient to prove the superiority of any surgical approach in terms of functional and oncologic outcomes. On the contrary, cost comparison clearly supports RRP.

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“…The postoperative erectile function outcomes for RRP, LRP, and RARP are shown in table 3 [14,16,18,20,21,22,25,30,39,43,45,50,52,54]. …”

Section: Resultsmentioning

confidence: 99%

“…The results for operative time, blood loss, blood transfusion rates, catheterisation time, hospital stay, and overall complication rates for RRP, LRP, and RALP are presented in table 2 [10,14,15,16,18,19,20,21,22,23,24,25,29,30,32,33,34,35,36,37,39,40,41,42,43,45,48,49,52,53,54,55]. …”

Section: Resultsmentioning

confidence: 99%

Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: Surgical, Oncological, and Functional Outcomes: A Systematic Review

et al. 2014

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“…With respect to perioperative variables, pooling data of 18 studies [ 21 , 23 , 24 , 26 , 29 , 32 , 34 , 40 , 54 , 59 , 60 , 64 , 70 , 75 , 78 , 81 , 84 , 85 ] involving 54261 participants indicated that RARP has longer operative time than RRP (WMD: 39.85 minutes; 95% CI: 20.95 to 58.75; P < 0.001) (Figure 2 ). Pooling data of 13 studies [ 10 , 21 , 23 , 29 , 30 , 34 , 40 , 60 , 70 , 75 , 78 , 84 , 85 ] results showed that RARP has less intraoperative blood loss (WMD = -507.67ml; 95% CI: -633.21 to -382.12; P < 0.001) (Figure 3 ).…”

Section: Resultsmentioning

confidence: 99%

Robotic vs. Retropubic radical prostatectomy in prostate cancer: A systematic review and a meta-analysis update

et al. 2016

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CONTEXTThe safety and feasibility of robotic-assisted radical prostatectomy (RARP) compared with retropubic radical prostatectomy(RRP) is debated. Recently, a number of large-scale and high-quality studies have been conducted.OBJECTIVETo obtain a more valid assessment, we update the meta-analysis of RARP compared with RRP to assessed its safety and feasibility in treatment of prostate cancer.METHODSA systematic search of Medline, Embase, Pubmed, and the Cochrane Library was performed to identify studies that compared RARP with RRP. Outcomes of interest included perioperative, pathologic variables and complications.RESULTS78 studies assessing RARP vs. RRP were included for meta-analysis. Although patients underwent RRP have shorter operative time than RARP (WMD: 39.85 minutes; P < 0.001), patients underwent RARP have less intraoperative blood loss (WMD = -507.67ml; P < 0.001), lower blood transfusion rates (OR = 0.13; P < 0.001), shorter time to remove catheter (WMD = -3.04day; P < 0.001), shorter hospital stay (WMD = -1.62day; P < 0.001), lower PSM rates (OR:0.88; P = 0.04), fewer positive lymph nodes (OR:0.45;P < 0.001), fewer overall complications (OR:0.43; P < 0.001), higher 3- and 12-mo potent recovery rate (OR:3.19;P = 0.02; OR:2.37; P = 0.005, respectively), and lower readmission rate (OR:0.70, P = 0.03). The biochemical recurrence free survival of RARP is better than RRP (OR:1.33, P = 0.04). All the other calculated results are similar between the two groups.CONCLUSIONSOur results indicate that RARP appears to be safe and effective to its counterpart RRP in selected patients.

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“…these points had more influence on urethrovesical anastomosis, bladder neck reconstruction, urethral and pelvic floor blood supply. 23 Di prerro et al reported RALP was higer postoperative recovery rate than RRP. 24 Tewari et al there was a differrence in that recovey period.…”

Section: Discussionmentioning

confidence: 96%

Experience on Early Urethral Catheter Removal Following Radical Prostatectomy

Yuk

Jung

Yoon

et al. 2016

Korean J Urol Oncol

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Purpose: To assess outcomes from patients who underwent radical prostatectomy and had their indwelling urinary catheter removed on postoperative day (POD) 4 or 7. Materials and Methods: The medical records of 107 consecutive patients receiving radical prostatectomy (RP), were retrospectively reviewed. Patients were categorized into two groups according to length of catheterization. Group 1 (n=40) had the urethral catheter removed on postoperative day (POD) 4, and group 2 (n=67) had the catheter removed on POD7. Group 1 had urethral catheter removal following no leakage on intraoperative leak testing and POD4 cystography, whilst group 2 exhibited leakage at POD4 and instead had routine POD7 urethral catheter removal if there was evidence of no leakage of POD7 cystography. Incontinence was checked according to the use of protective pad. Results: The mean age of the study population was 67.0 years. acute urinary retension (AUR) following catheter removal occurred in 6 of the cohort (5.6%); 3 patients (7.5%) from group 1 and 3 (4.5%) from group 2 (p=0.669). The overall continence rate was 39.3%, 68.2%, 80.4%, and 91.6% at 1, 3, 6, and 12 months respectively. Importantly, the incontinence recovery pace of group 1 was notably higher than that of group 2 (p=0.001). Neither group exhibited bladder neck contracture. Intraoperative factors influencing the decision to remove catheter at POD4 following RP, are bladder neck reconstruction (OR=3.792, p=0.010) and nerve sparing (OR=6.646, p=0.008). Conclusions: Selective early urethral catheter removal may shorten the length of incontinence recovery, without increasing the risk of AUR and bladder neck contracture.

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Comparison of Continence Recovery Between Robot-Assisted Laparoscopic Prostatectomy and Open Radical Retropubic Prostatectomy: A Single Surgeon Experience

Cited by 22 publications

References 21 publications

Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: Surgical, Oncological, and Functional Outcomes: A Systematic Review

Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: Surgical, Oncological, and Functional Outcomes: A Systematic Review

Robotic vs. Retropubic radical prostatectomy in prostate cancer: A systematic review and a meta-analysis update

Experience on Early Urethral Catheter Removal Following Radical Prostatectomy

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