Objectives: After radical prostatectomy, surgical margin positivity is an important indicator of biochemical recurrence and progression. In our study we want to compare the surgical margin positivity rates for retropubic radical prostatectomy (RRP) and robotic assisted radical prostatectomy (RALP) and investigate the factors affecting surgical margin positivity in RALP. Materials and methods: Data from 78 RRP and 62 RALP patients operated from 2011 May to 2016 March were retrospectively screened. Patients in both groups were compared in terms of age, postop hematocrit reduction, hospital stay, duration of follow-up, surgical margin positivity, biochemical recurrence and oncologic parameters. In RALP group it was searched the relationship between the surgical margin positivity and prostate specific antigen (PSA), positive biopsy core, biopsy Gleason scoring, pathologic stage and Gleason scoring, lymph node positivity, lymphovascular and perineural invasion, extracapsular extension, seminal vesicle invasion, prostate weight. Additionally the high cost associated with robotic radical prostatectomy has led to questions about the necessity for use of this technique in developing countries such as ours (10). Surgical margin positivity after radical prostatectomy is one of the important causes of biochemical recurrence and progression. When comparing retropubic radical prostatectomy (RRP) and RARP one of the important topics of interest is the effect on surgical margin positivity. In this study we compared the surgical margin positivity rates of RRP and RARP and aimed to investigate the factors affecting surgical margin positivity in RARP.
MATERIALS AND METHODSThe data belonging to 173 patients who underwent RRP or RARP for prostate cancer, without neo-adjuvant therapy, at our center from May 2011 to March 2016 were retrospectively scanned. Our study was in accordance with the Helsinki Declaration and did not gain ethics committee permission as it included retrospective data. While RRP was performed with the classic retropubic technique, the robotic technique used the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA) with 5 port transperitoneal approach. The operations were performed by 3 different surgeons experienced in open surgery and inexperienced in robotic surgery. Patients with lymph node metastasis risk above 5% according to the Briganti nomogram (11) had extended lymph node dissection (2) performed. For low risk prostate cancer (T1c, PSA < 10, Gleason < 7) patients, a nerve-sparing approach was chosen. Patients who underwent RRP had a urethral Foley catheter inserted for 2 weeks, while RARP patients had a catheter inserted for 1 week. The patient age, prostate