Complications associated with extraperitoneal robot-assisted radical prostatectomy using the standardized Martin...

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is a common treatment for localized prostate cancer.
• The extraperitoneal approach to RARP is less frequently utilized but offers potential advantages.

Purpose of the Study:

• To analyze the incidence and predictors of early and long-term complications following extraperitoneal RARP.
• To evaluate the safety and efficacy of the extraperitoneal approach using standardized criteria.

Main Methods:

• A retrospective review of 1503 patients undergoing extraperitoneal RARP for localized prostate cancer.
• Complications were classified using the Martin criteria.
• Bivariate and multivariate logistic regression analyses identified predictors of complications.

Main Results:

• 8.45% of patients experienced 151 complications; 30.5% were major complications.
• The most frequent complications included lymphocele, bladder neck contracture, and anastomotic leak.
• Increased operative time and surgeon experience were significant predictors of complications.

Conclusions:

• Extraperitoneal RARP is a safe and effective treatment for localized prostate cancer when performed by experienced surgeons.
• The complication profile is comparable to other RARP approaches.
• This technique remains underutilized despite its favorable safety profile.