[Radical prostatectomy: evaluation of learning curve outcomes laparoscopic and robotic-assisted laparoscopic...

Radical retropubic prostatectomy (RRP) is the gold standard for the surgical treatment of localized prostate cancer. New techniques are being developed with less invasive methods, including laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic radical prostatectomy (RALP). The aim of the study is to compare LRP and RALP outcomes during the learning curve with RRP, especially operative time and surgical complications.

We performed a retrospective observational study of all the RRP cases attended from January 2000, allthe LRPs performed at the Urology Department of the Galdakao Usansolo Hospital and the first 60 RALPs treated by the Clinic Urology group. Baseline parameters, operative and perioperative parameters (nerve preservation, positive margins, intraoperative bleeding, duration of catheterization, hospital stay) and surgical complications were assessed, and the three techniques were compared.

The total number of patients was 192. The mean time operation was of 210 min in the RRP group, 345 min in the LRP group and 209.5 min in the RALP group (p = 0). Intraoperative bleeding was of 1500 mL in RRP, 1275 mL in LRP and 400 mL in RALP (p = 0) (Table 1). Six months after the procedure the continence rate was 60% in the RALP group, 45.90% in the RRP group and 36.40% in the group LRP (p = 0.001) (Table 2).

Laparoscopic radical prostatectomy requires a longer learning curve than robotic-assisted prostatectomy. Operative time in RALP procedures was comparable to RRP cases. RALP showed benefits in terms of continence and intraoperative bleeding.