Robot-Assisted Versus Open Simple Prostatectomy for Benign Prostatic Hyperplasia in Large Glands: A Propensity Score–Matched Comparison of Perioperative and Short-Term Outcomes

Sorokin, Igor; Sundaram, Varun; Singla, Nirmish; Walker, Joan; Margulis, Vitaly; Roehrborn, C.; Gahan, Jeffrey

doi:10.1089/end.2017.0489

Cited by 80 publications

(51 citation statements)

References 26 publications

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“…In contrast to our findings, no difference regarding 90-day complications and rate of postoperative blood transfusions between OSP and RASP patients has been reported [10]. Similarly, Sorokin and collaborators showed a shorter hospital stay, longer operative time and lower estimated blood loss for RASP patients in their propensity score-matched comparison but no significant difference of complications or rate of blood transfusions [11]. In line with existing studies, Mourmouris and co-workers reported of a longer operative time, shorter hospital stay and lower estimated blood loss for RASP patients.…”

Section: Discussioncontrasting

confidence: 99%

“…Hoy et al retrospectively reviewed 4 RASP patients and 28 OSP patients [10]. In a larger retrospective study, propensity score-matched cohorts of 59 OSP patients and 59 RASP patients were compared [11]. In the only prospective comparative trial available, Mourmouris et al compared 15 OSP patients and 26 RASP patients in a non-randomized multi-center study [12].…”

Section: Introductionmentioning

confidence: 99%

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Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

et al. 2020

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Purpose Open simple prostatectomy (OSP) is a standard surgical technique for patients with benign prostatic hyperplasia with prostate size larger than 80 ml. As a minimally invasive approach, robot-assisted simple prostatectomy (RASP) emerged as a feasible surgical alternative. Currently, there are no definite recommendations for the standard use of RASP. Therefore, we aimed at investigating various clinical outcomes comparing RASP with OSP. Methods In this retrospective single-center study, we evaluated clinical data from 103 RASP and 31 OSP patients. Both cohorts were compared regarding different clinical characteristics with and without propensity score matching. To detect independent predictive factors for clinical outcomes, multivariate logistic regression analysis was performed. Results Robot-assisted simple prostatectomy patients demonstrated a lower estimated blood loss and need for postoperative blood transfusions as well as less postoperative complications. OSP had a shorter operative time (125 min vs. 182 min) longer hospital stay (11 days vs. 9 days) and longer time to catheter removal (8 days vs. 6 days). In the multivariate analysis, RASP was identified as an independent predictor for longer operative time, lower estimated blood loss, shorter length of hospital stay, shorter time to catheter removal, less postoperative complications and blood transfusions. Conclusion Robot-assisted simple prostatectomy is a safe alternative to OSP with less perioperative and postoperative morbidity. Whether OSP (shorter operative time) or RASP (shorter length of hospital stay) has a more favorable economic impact depends on the particular conditions of different health care systems. Further prospective comparative research is warranted to define the value of RASP in the current surgical management of benign prostatic hyperplasia.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

et al. 2020

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“…Operating room time efficiency, an important advantage noticed during the WATER study where procedure and resection times were only marginally impacted by prostate volume, remained favourable in the present study in men with larger prostates. Total operating time and total resection time were 37 and 8 min, respectively, which were considerably shorter than the average time required to perform open prostatectomy (95 min ), HoLEP (91 min ), or PVP (93 min ) on a 100‐mL prostate.…”

Section: Discussionmentioning

confidence: 90%

Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial

et al. 2019

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Objective To present 6‐month safety and effectiveness data from a multicentre prospective study of aquablation in men with lower urinary tract symptoms (LUTS) attributable to benign prostatic hyperplasia (BPH) with prostate volumes between 80 and 150 mL. Methods Between September and December 2017, 101 men with LUTSattributable to BPHwere prospectively enrolled at 16 centres in Canada and the USA. Results The mean prostate volume was 107 mL. The mean length of hospital stay after the aquablation procedure was 1.6 days (range: same day to 6 days). The primary safety endpoint (Clavien–Dindo grade 2 or higher or any grade 1 event resulting in persistent disability) at 3 months occurred in 45.5% of men, which met the study design goal of < 65% (P < 0.001). At 6 months, 22% of the patients had experienced a Clavien–Dindo grade 2, 14% a grade 3 and 5% a grade 4 adverse event. Bleeding complications requiring intervention and/or transfusion were recorded in eight patients prior to discharge and in six patients after discharge. The mean International Prostate Symptom Score improved from 23.2 ± 6.3 at baseline to 6.7 ± 5.1 at 3 months, meeting the study's primary efficacy endpoint goal (P < 0.001). The maximum urinary flow rate increased from 8.7 to 18.8 mL/s (P < 0.001) and post‐void residual urine volume decreased from 131 at baseline to 47 at 6 months (P < 0.0001). At 6 months, prostate‐specific antigen concentration reduced from 7.1 ± 5.9 ng/mL at baseline to 4.0 ± 3.9 ng/mL, a 44% reduction. Conclusions Aquablation is safe and effective in treating men with larger prostates (80–150 mL), without significant increase in procedure or resection time.

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“…Interestingly, there are only two papers in the literature directly comparing OSP and RASP, but both are limited by their retrospective nature. Sorokin et al [9] matched 59 patients undergoing OSP with 59 patients undergoing RASP. In that study, the authors reported favourable outcomes in terms of length of hospital stay (LOS; P < 0.001), estimated blood loss (EBL; P < 0.001), PVR (P = 0.007), and complication rate for the RASP group (P = 0.381), whereas the OSP group was better in terms of operating time.…”

Section: Discussionmentioning

confidence: 99%

A prospective comparative analysis of robot‐assisted vs open simple prostatectomy for benign prostatic hyperplasia

et al. 2018

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Robot-Assisted Versus Open Simple Prostatectomy for Benign Prostatic Hyperplasia in Large Glands: A Propensity Score–Matched Comparison of Perioperative and Short-Term Outcomes

Abstract: Robotic simple prostatectomy is a safe and effective treatment for the surgical management of benign prostatic hyperplasia. It provides similar function outcomes to the open approach; however, offers the advantage of reduced LOS and reduced blood loss.

Cited by 80 publications

References 26 publications

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

Robot-assisted simple prostatectomy versus open simple prostatectomy: a single-center comparison

Aquablation for benign prostatic hyperplasia in large prostates (80–150 mL): 6‐month results from the WATER II trial

A prospective comparative analysis of robot‐assisted vs open simple prostatectomy for benign prostatic hyperplasia

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