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R-LESS-RP versus C-LESS-RP: a single-institution retrospective comparative study
Yong Wei1,2, Qianying Ji2, Xin Zhou3
1Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210000, China.
Scientific Reports
|March 8, 2023
Summary
Robot-assisted laparoendoscopic single-site radical prostatectomy (R-LESS-RP) offers improved perioperative outcomes, including reduced operation time and blood loss, compared to conventional methods. While R-LESS-RP shows benefits in urinary continence recovery and quality of life, it incurs higher costs.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Radical prostatectomy is a primary treatment for prostate cancer.
- Laparoendoscopic single-site surgery (LESS) aims to minimize surgical invasiveness.
- Robot-assisted surgery offers enhanced dexterity and visualization in minimally invasive procedures.
Purpose of the Study:
- To compare perioperative and postoperative outcomes between conventional LESS radical prostatectomy (C-LESS-RP) and robot-assisted LESS radical prostatectomy (R-LESS-RP).
- To evaluate the efficacy and patient-reported outcomes of R-LESS-RP versus C-LESS-RP in prostate cancer treatment.
Main Methods:
- Retrospective analysis of data from 230 prostate cancer patients (106 C-LESS-RP, 124 R-LESS-RP).
- All surgeries performed by the same surgeon between January 2018 and January 2021.
- Comparison of clinical characteristics, perioperative metrics (operation time, blood loss, analgesic duration), and postoperative outcomes (urinary incontinence, quality of life, recurrence).
Main Results:
- R-LESS-RP demonstrated significantly shorter operation times (120 vs. 150 min), less estimated blood loss (17.68 vs. 33.68 ml), and shorter analgesic duration (0 vs. 1 day) compared to C-LESS-RP.
- No significant differences were observed in drainage tube duration or postoperative hospital stay between the groups.
- R-LESS-RP patients showed improved urinary incontinence recovery and higher quality of life scores, despite a higher cost (56559.51 CNY vs. 44818.27 CNY); biochemical recurrence rates were similar.
Conclusions:
- Robot-assisted laparoendoscopic single-site radical prostatectomy (R-LESS-RP) offers superior perioperative outcomes and faster recovery of urinary continence compared to conventional LESS-RP, particularly for experienced surgeons.
- R-LESS-RP provides enhanced health-related quality of life benefits, justifying the increased cost for selected patients.
- Further research may explore long-term oncological control and cost-effectiveness in diverse patient populations.
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