Outcomes and Complications of Robotic-assisted Laparoscopic Prostatectomy in a Community Hospital Setting

To evaluate outcomes for 144 robotic-assisted laparoscopic prostatectomies (RALPs) conducted upon introduction of a robotic surgery program in a community hospital.

Patient data were reviewed for 144 patients who underwent RALP from January 2013 to February 2015. Complications and oncologic and functional outcomes were assessed. Student t test and analysis of variance were used to compare differences among study groups.

Median age was 64 (IQR 60-68) and median prostate-specific antigen was 5.61 (interquartile range [IQR] 4.3-7.7). Stage pT2, pT3a, and 3b pathology was present at rates of 77%, 21%, and 8%, respectively. Median operative blood loss was 200 mL (IQR 150-300), median operative time was 1.75 hours (IQR 1.5-2.3), and median length of stay was 2 days (IQR 1-2). Overall, there were 9 complications (6.8%); 2 were classified as major and 7 as minor events. The overall positive surgical margin rate was 19%, with positive surgical margin rates of 11% and 46.8% in patients with pT2 and pT3 disease, respectively (P < .001). The overall biochemical recurrence rate at 12 months was 12.5% occurring in 10% and 20% of patients with pT2 and pT3 disease, respectively (P = .32). Continence success at 1, 6, and 12 months was 67%, 90%, and 93%, respectively. Potency success in men with normal to mild erectile dysfunction at baseline was 76% and 83% at 6 and 12 months, respectively.

RALP in this community hospital practice was both safe and effective. Complication rates and oncologic and functional outcomes in this study were commensurate with those reported by high volume centers.