Robotic-assisted perineal versus transperitoneal radical prostatectomy: A matched-pair analysis

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robotic radical prostatectomy is a standard treatment for localized prostate cancer.
• Comparing different surgical approaches is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the outcomes of robotic-assisted radical perineal prostatectomy (r-PRP) versus robotic-assisted transperitoneal laparoscopic radical prostatectomy (RARP).

Main Methods:

• A comparative study of 80 patients (40 r-PRP, 40 RARP) with localized prostate cancer (C-T2N0M0).
• Exclusion criteria included locally advanced disease, high Gleason score, and prior pelvic treatments.
• Patients were positioned in exaggerated lithotomy for r-PRP and Trendelenburg for RARP.

Main Results:

• r-PRP group had significantly lower body mass index and estimated blood loss.
• Mean console and anastomosis times were significantly lower in the r-PRP group.
• Higher continence rates at 6 and 9 months (94.2%, 95% for r-PRP vs. 72%, 85.2% for RARP) and improved erectile function at 3, 6, and 9 months (44%, 66%, 75% for r-PRP vs. 25%, 42%, 66% for RARP) were observed in the r-PRP group.

Conclusions:

• Robotic-assisted radical perineal prostatectomy (r-PRP) offers acceptable morbidity with excellent surgical and pathological outcomes.
• r-PRP demonstrated satisfactory oncologic and functional results, particularly in continence and erectile function, compared to RARP.