Contemporary Comparison of Open to Robotic Prostatectomy at a Veteran’s Affairs Hospital

Desai, Angel N.; Hudnall, Matthew; Weiner, Adam B.; Patel, Mehul S.; Cohen, Jason; Gogana, Pooja; Sharifi, R.; Meeks, Joshua J.

doi:10.1093/milmed/usy352

Cited by 6 publications

(2 citation statements)

References 28 publications

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“…Based on a matched-pair analysis, d’Altilia et al demonstrated a higher proportion of patients with urinary incontinence following ORP compared to RARP [ 15 ]. In addition, soft criteria such as length of hospital stay and intraoperative blood loss have been shown to significantly improve with RARP as opposed to ORP [ 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Patients Regret Their Choice of Therapy Significantly Less Frequently after Robot-Assisted Radical Prostatectomy as Opposed to Open Radical Prostatectomy: Patient-Reported Results of the Multicenter Cross-Sectional IMPROVE Study

Wolff

Burchardt

Gilfrich

et al. 2022

Cancers

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Patient’s regret (PatR) concerning the choice of therapy represents a crucial endpoint for treatment evaluation after radical prostatectomy (RP) for prostate cancer (PCA). This study aims to compare PatR following robot-assisted (RARP) and open surgical approach (ORP). A survey comprising perioperative-functional criteria was sent to 1000 patients in 20 German centers at a median of 15 months after RP. Surgery-related items were collected from participating centers. To calculate PatR differences between approaches, a multivariate regressive base model (MVBM) was established incorporating surgical approach and demographic, center-specific, and tumor-specific criteria not primarily affected by surgical approach. An extended model (MVEM) was further adjusted by variables potentially affected by surgical approach. PatR was based on five validated questions ranging 0–100 (cutoff >15 defined as critical PatR). The response rate was 75.0%. After exclusion of patients with laparoscopic RP or stage M1b/c, the study cohort comprised 277/365 ORP/RARP patients. ORP/RARP patients had a median PatR of 15/10 (p < 0.001) and 46.2%/28.1% had a PatR >15, respectively (p < 0.001). Based on the MVBM, RARP patients showed PatR >15 relative 46.8% less frequently (p < 0.001). Consensual decision making regarding surgical approach independently reduced PatR. With the MVEM, the independent impact of both surgical approach and of consensual decision making was confirmed. This study involving centers of different care levels showed significantly lower PatR following RARP.

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Section: Introductionmentioning

confidence: 99%

Patients Regret Their Choice of Therapy Significantly Less Frequently after Robot-Assisted Radical Prostatectomy as Opposed to Open Radical Prostatectomy: Patient-Reported Results of the Multicenter Cross-Sectional IMPROVE Study

Wolff

Burchardt

Gilfrich

et al. 2022

Cancers

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“…Twenty-seven studies were retrospective non-randomized,52–57,60,62,63,65–70,72,73,75,76,78,79,81–84,86,87 eight studies were prospective non-randomized58,59,61,64,71,74,77,85 and one study was prospective randomized 80. Twelve studies were from the USA,52,56,58,64,66,67,69,70,74,75,79,87 one from the UK,78 one from Germany,85 three from France,61,80,82 one from Belgium,53 three from Italy,62,71,81 one from Norway,68 two from Sweden,57,86 one from Switzerland,59 three from Australia,60,77,88 one from Canada,73 three from South Korea,65,83,84 one from Taiwan,76 one from Thailand54 and one from Venezuela,72 while one study was multinational 63. Thirteen articles compared robotic with laparoscopic operations,53,54,63,65,67,68,71,76,79–81,84,87 19 articles compared robotic with open procedures,52,55–59,61,62,66<...>…”

Section: Resultsmentioning

confidence: 99%

<p>Comparison Between Robotic and Laparoscopic or Open Anastomoses: A Systematic Review and Meta-Analysis</p>

Kostakis

Sran

Uwechue

et al. 2019

RSRR

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Introduction: Robotic surgery has been increasingly used in fashioning various surgical anastomoses. Our aim was to collect and analyze outcomes related to anastomoses performed using a robotic approach and compare them with those done using laparoscopic or open approaches through meta-analysis. Methods: A systematic review was conducted for articles comparing robotic with laparoscopic and/or open operations (colectomy, low anterior resection, gastrectomy, Roux-en-Y gastric bypass (RYGB), pancreaticoduodenectomy, radical cystectomy, pyeloplasty, radical prostatectomy, renal transplant) published up to June 2019 searching Medline, Scopus, Google Scholar, Clinical Trials and the Cochrane Central Register of Controlled Trials. Studies containing information about outcomes related to hand-sewn anastomoses were included for meta-analysis. Studies with stapled anastomoses or without relevant information about the anastomotic technique were excluded. We also excluded studies in which the anastomoses were performed extracorporeally in laparoscopic or robotic operations. Results: We included 83 studies referring to the aforementioned operations (4 randomized controlled and 79 non-randomized, 10 prospective and 69 retrospective) apart from colectomy and low anterior resection. Anastomoses done using robotic instruments provided similar results to those done using laparoscopic or open approach in regards to anastomotic leak or stricture. However, there were lower rates of stenosis in robotic than in laparoscopic RYGB (p=0.01) and in robotic than in open radical prostatectomy (p<0.00001). Moreover, all anastomoses needed more time to be performed using the robotic rather than the open approach in renal transplant (p≤0.001). Conclusion: Robotic anastomoses provide equal outcomes with laparoscopic and open ones in most operations, with a few notable exceptions.

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Challenge and future of liver and pancreatic robotic surgery. Analysis of 64 cases in a specialized unit

Andorrà

Pérez

López

et al. 2022

Cirugía Española (English Edition)

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Contemporary Comparison of Open to Robotic Prostatectomy at a Veteran’s Affairs Hospital

Cited by 6 publications

References 28 publications

Patients Regret Their Choice of Therapy Significantly Less Frequently after Robot-Assisted Radical Prostatectomy as Opposed to Open Radical Prostatectomy: Patient-Reported Results of the Multicenter Cross-Sectional IMPROVE Study

Patients Regret Their Choice of Therapy Significantly Less Frequently after Robot-Assisted Radical Prostatectomy as Opposed to Open Radical Prostatectomy: Patient-Reported Results of the Multicenter Cross-Sectional IMPROVE Study

<p>Comparison Between Robotic and Laparoscopic or Open Anastomoses: A Systematic Review and Meta-Analysis</p>

Challenge and future of liver and pancreatic robotic surgery. Analysis of 64 cases in a specialized unit

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