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KMID : 0358320090500050468
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Korean Journal of Urology
2009 Volume.50 No. 5 p.468 ~ p.474
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Comparison of Initial Surgical Outcomes between Laparoscopic Radical Prostatectomy and Robot- Assisted Laparoscopic Radical Prostatectomy Performed by a Single Surgeon
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Lee Hye-Won
Lee Hyun-Moo
Seo Seong-Il
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Abstract
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Purpose: Pure laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP) are less invasive alternative techniques for localized prostate cancer. We report our initial surgical experience of LRP and RALP performed by a single surgeon.
Materials and Methods: Between October 2007 and August 2008, 31 and 21 patients were treated with LRP and RALP by the same surgeon, respectively, and both groups were similar in preoperative clinical parameters, including serum prostate-specific antigen (PSA) level, Gleason score (GS), and clinical stage. We analyzed the perioperative parameters and early short-term surgical outcome of LRP and RLRP by retrospective chart review.
Results: The mean surgical times for LRP and RALP were 279 and 337 min, respectively, and other perioperative data showed no significant differences between the 2 groups (all p＞0.05) with the exception of the preservation rate of neurovascular bundles (58% LRP and 95% RALP, p=0.008). The pathologic parameters including the positive surgical margin rate of the 2 groups were comparable (29% LRP and 29% RALP, p＞0.05). Immediately and at 1 month after catheter removal, the RALP group showed a better continence rate than did the LRP group (all p＜0.05), but the overall continence rate was similar (80.6% LRP and 81% RALP, p=1.00). Operative charges for RALP were almost 9.4 times as high as those for LRP (p=0.03).
Conclusions: We found comparable efficacy and safety of LRP and RALP for localized prostate cancer in this study. Although RALP showed a better short-term continence rate, LRP was analyzed as being the more cost- effective procedure.
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KEYWORD
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Prostatic neoplasms, Prostatectomy, Robotics, Laparoscopy
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