Journal List > Korean J Urol > v.50(5) > 1005332

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Lee, Lee, and Seo: Comparison of Initial Surgical Outcomes between Laparoscopic Radical Prostatectomy and Robot-Assisted Laparoscopic Radical Prostatectomy Performed by a Single Surgeon
Original Article
Endourology/Urolithiasis
Korean Journal of Urology

Korean Journal of Urology 2009; 50(5): 468-474.

Published online: 26 May 2009

DOI: https://doi.org/10.4111/kju.2009.50.5.468

Comparison of Initial Surgical Outcomes between Laparoscopic Radical Prostatectomy and Robot-Assisted Laparoscopic Radical Prostatectomy Performed by a Single Surgeon

Hye Won Lee, Hyun Moo Lee, Seong Il Seo

Department of Urology, Sungkyunkwan University College of Medicine, Seoul, Korea.

Correspondence to: Seong Il Seo. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. TEL: 02-3410-3556, FAX: 02-3410-3027, seongil.seo@samsung.com

Received 25 February 2009       Accepted 6 April 2009

Copyright © The Korean Urological Association, 2009

Abstract

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.

Keywords: Prostatic neoplasms, Prostatectomy, Robotics, Laparoscopy

Figures and Tables

Fig. 1
Operation times (min) according to case group. LRP: laparoscopic radical prostatectomy, RALP: robotic-assisted laparoscopic radical prostatectomy.
kju-50-468-g001
Table 1
Preoperative characteristics of the patients who underwent laparoscopic or robot-assisted laparoscopic radical prostatectomy
kju-50-468-i001

LRP: laparoscopic radical prostatectomy, RALP: robotic-assisted laparoscopic radical prostatectomy, PSA: prostate-specific antigen, BMI: body mass index, a: Student's t-test, b: chi-square test

Table 2
Various intraoperative and postoperative parameters according to operative method
kju-50-468-i002

LRP: laparoscopic radical prostatectomy, RALP: robotic-assisted laparoscopic radical prostatectomy, a: Student's t-test, b: chi-square test

Table 3
Pathologic stage versus surgical margin status according to operative method
kju-50-468-i003

LRP: laparoscopic radical prostatectomy, RALP: robotic-assisted laparoscopic radical prostatectomy, a: Fisher's exact test

Table 4
Complications and management according to operative method
kju-50-468-i004

LRP: laparoscopic radical prostatectomy, RALP: robotic-assisted laparoscopic radical prostatectomy

Table 5
Postoperative functional outcomes
kju-50-468-i005

LRP: laparoscopic radical prostatectomy, RALP: robotic-assisted laparoscopic radical prostatectomy, a: chi-square test

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