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Perioperative, Oncological, and Functional Outcomes Between Robot-Assisted Laparoscopic Prostatectomy and Open
William Carlos Nahas1, Gilberto José Rodrigues1, Fabio Augusto Rodrigues Gonçalves2
1Urologia, Instituto do Cancer do Estado de São Paulo Octavio Frias de Oliveira, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
The Journal of Urology
|May 9, 2024
Summary
Robot-assisted laparoscopic prostatectomy (RALP) offers improved sexual and urinary outcomes compared to open surgery, with similar complication rates. Oncological outcomes remain comparable between the two procedures.
Area of Science:
- Urology
- Surgical Oncology
- Robotic Surgery
Background:
- Robot-assisted laparoscopic prostatectomy (RALP) and open retropubic radical prostatectomy are surgical options for prostate cancer.
- High-quality comparative studies on their postoperative outcomes are limited.
Purpose of the Study:
- To compare the postoperative outcomes of RALP versus open retropubic radical prostatectomy in a randomized trial.
- To evaluate complication rates, functional outcomes, quality of life, and oncological results.
Main Methods:
- A single-center randomized trial involving 342 men with newly diagnosed prostate cancer.
- Patients were randomized (1:1) to undergo either RALP or open retropubic radical prostatectomy.
- Outcomes assessed included 90-day complications, functional status (urinary and sexual), quality of life over 18 months, and oncological outcomes over 36 months.
Main Results:
- RALP was associated with significantly lower median bleeding and shorter hospitalization.
- Urinary continence rates at 3, 6, and 18 months were significantly higher in the RALP group.
- Sexual function scores and potency rates were superior in the RALP group up to 12 months post-surgery.
Conclusions:
- While 90-day complication rates were similar, RALP demonstrated superior sexual outcomes at 1 year and improved urinary outcomes at 18 months.
- Oncological outcomes were comparable between RALP and open surgery at 36 months.
- RALP presents advantages in functional recovery compared to open surgery for prostate cancer treatment.
