[Multicenter comparison of complications after robot-assisted and open simple prostatectomy]

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Benign prostate hyperplasia (BPH) affects a significant portion of the aging male population.
• Symptomatic BPH often requires surgical intervention when conservative treatments fail.
• Robot-assisted simple prostatectomy (RASP) is an emerging minimally invasive option for large prostates (>80 cm³).

Purpose of the Study:

• To compare the postoperative morbidity of Robot-assisted simple prostatectomy (RASP) versus Open Simple Prostatectomy (OSP).
• To evaluate hematological parameters and complication rates between RASP and OSP.
• To assess the safety and efficacy of RASP for managing large prostates.

Main Methods:

• Retrospective review of 78 patients (39 RASP, 39 OSP).
• Comparison of demographic data, prostate volume, operative time, hospital stay, hemoglobin decrease, C-reactive protein (CRP) levels, and transfusion rates.
• Statistical analysis of Clavien-Dindo scores and hematological parameters.

Main Results:

• RASP showed significantly lower postoperative Clavien-Dindo scores (0.44 vs. 1.23) and reduced blood loss (Hb decrease: 1.9 vs. 3.3 g/dL).
• RASP patients required fewer blood transfusions (3% vs. 26%) and had lower CRP levels (52 vs. 104 mg/L).
• Operative time was longer in RASP (178 vs. 110 min), but other parameters like age, PSA, and prostate volume were comparable.

Conclusions:

• RASP is a safe and effective minimally invasive procedure for BPH, associated with reduced blood loss and complications.
• OSP demonstrated a higher incidence of bleeding complications, prolonged hospitalization, and increased need for blood transfusions.
• The lower invasiveness of RASP contributes to a reduced inflammatory response, indicated by lower CRP levels.