Herrera-Muñoz JA, Gómez-Sánchez J, Preciado-Estrella D, Trujillo-Ortiz L, Sedano-Basilio J, López-Maguey RP, Sánchez-Aquino U, Viana-Álvarez G, Veliz-Cabrera G, Cortes-Raygosa P, Ortega-González M, Calvo-Vázquez I, Hernández-Méndez E, Fernández-Noyola G, Cantellano-Orozco M, Martínez-Arroyo C, Morales-Montor JG, Pacheco-Gahbler C

Language: Spanish
References: 15
Page: 173-182
PDF size: 220.94 Kb.

ABSTRACT

Background: Perioperative, oncologic, and functional results between open radical prostatectomy and robotic-assisted laparoscopic radical prostatectomy are still the subject of debate.
Objective: To compare the perioperative, oncologic, and functional results between open radical prostatectomy and robotic-assisted laparoscopic radical prostatectomy.
Materials and methods: A retrospective, descriptive, and analytic study was conducted by analyzing the medical records of patients that underwent robotic-assisted laparoscopic radical prostatectomy and patients that underwent open radical prostatectomy, within the time frame of January 2012 and June 2016. The follow-up period for the patients with robotic-assisted prostatectomy was from 3 to 21 months and that of open radical prostatectomy was from 1 to 4 years. Preoperative variables (age, ECOG functional status, comorbidities, prostate-specific antigen concentration, Gleason score, NCCN risk group), perioperative variables (intraoperative blood loss, surgery duration, days of hospital stay, time with transurethral catheter, postoperative complications), and oncologic variables (clinical stage, surgical specimen Gleason criteria, positive surgical margins, disease persistence and biochemical recurrence, urinary continence [at 3, 6, and 12 months], sexual potency or performance [at 6 and 12 months]) were analyzed. The SPSS program was used for the statistical analysis. Frequencies were calculated and normality tests were performed. The Pearson’s χ² test was employed for the qualitative variables and the Student’s t test and Mann-Whitney U test were used for the quantitative variables.
Results: Thirty-five patients underwent robotic-assisted laparoscopic radical prostatectomy and 36 had open radical prostatectomy. For robotic-assisted laparoscopic radical prostatectomy versus open radical prostatectomy, the mean age of the patients was 64 vs 63 years, surgery duration was 286 min (68) vs 225 min (± 65) (p ‹ 0.001). intraoperative blood loss was 869 mL (± 657) vs 1567 mL (± 1110) (p=0.001), and the transfusion rate was 37 vs 47% (p=0.26), respectively. Mean hospital stay was 5 days for the two procedures. Postoperative complications presented in 29 vs 28% (p=0.58) of the patients, there were positive surgical margins in 63 vs 33% (p=0.01), and the continence rate at 3 months was 57 vs 53% (p=0.7), respectively.
Conclusions: Our study confirmed the benefits of robotic-assisted laparoscopic radical prostatectomy in relation to intraoperative blood loss and transfusion. In addition, the rest of the parameters evaluated were similar, but not inferior, to those for open radical prostatectomy.

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