Laparoscopic Versus Open Radical Prostatectomy: A Comparative Study at a Single Institution

Rassweiler, Jens; Seemann, O.; Schulze, Michael; Teber, Doğu; Hatzinger, Martin; Frede, Thomas

doi:10.1097/01.ju.0000062614.56629.41

Cited by 354 publications

(189 citation statements)

References 18 publications

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“…Whereas no previous study has assessed RALP versus RRP in terms of sick leave, studies have compared convalescence between conventional laparoscopic radical prostatectomy and RRP and found, in agreement with the present data, that patients operated on with the laparoscopic procedure had a shorter period of convalescence than patients operated on with RRP [6,7].…”

Section: Discussionsupporting

confidence: 81%

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Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: A comparison of length of sick leave

Hohwü

Akre

Pedersen

et al. 2009

Scandinavian Journal of Urology and Nephrology

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Objective. It remains uncertain whether the increased direct costs of robot-assisted laparoscopic radical prostatectomy (RALP) are outweighed by cost savings due to shorter postoperative hospital care and shorter sick leave. This study compared the length of sick leave after RALP with that after radical retropubic prostatectomy (RRP). Material and methods. In a cohort study, information on length of sick leave was retrieved for 274 working men undergoing radical prostatectomy (127 RALP and 147 RRP). Data on confounders such as physical workload, average salary, body mass index and disease characteristics were collected from the medical records. Cox regression models were used to compare the treatment groups. Results. The median number of days with sick leave was 11 in the RALP group and 49 in the RRP group. After adjustment for confounders, patients in the RALP group were twice as likely to return to work at any time during follow-up (hazard ratio 02.13, 95% confidence interval 1.62Á2.80). High physical workload, low salary and high tumour grade were more common in the RRP group and associated with longer sick leave. Conclusions. Patients in the RALP group had shorter postoperative hospital stay and less need for paid sick leave than patients in the RRP group. These data indicate that RALP shortens the convalescence. Part of this difference may, however, be attributable to different selection of patients and different a priori expectations among patients and their doctors. A prospective randomized study is advocated, although blinding is unfeasible.

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Section: Discussionsupporting

confidence: 81%

“…It has been reported that conventional laparoscopic radical prostatectomy is associated with a shorter convalescence period than RRP [6,7], but comparative evaluations between RALP and RRP are lacking.…”

Section: Introductionmentioning

confidence: 99%

Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: A comparison of length of sick leave

Hohwü

Akre

Pedersen

et al. 2009

Scandinavian Journal of Urology and Nephrology

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“…Unfortunately, after a large learning curve of their 550 patients, Guillonneau et al 22 reported that 31/47 consecutive (66%) preoperatively potent patients, who underwent bilateral nerve-sparing surgery, were able to have intercourse with or without sildenafil ( Table 2). Rassweiller et al 23 reported in their first 180 laparoscopic RP series that 4/10 (40%) patients with nerve sparing had erections sufficient for vaginal intercourse with sildenafil. Katz et al 24 reported that, of 143 preoperatively potent patients, only 23% were able to have sexual intercourse at 12 months.…”

Section: Radical Perineal Prostatectomy (Rpp)mentioning

confidence: 99%

Sexual dysfunction after pelvic surgery

et al. 2005

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Pelvic surgeries are among the most common causes of organic sexual dysfunction in men and women. The impact of nerve-sparing surgery on potency has been well documented in radical prostatectomy. However, its impact on potency needs to be evaluated in other pelvic surgeries. Sexual dysfunction is highly prevalent even after multiple technical advances in the field of oncological surgeries. The prevalence varies from 8 to 82%, depending on the type of pelvic surgery. In females, sexual dysfunction has not been evaluated adequately using validated questionnaires. However, in subspecialized circles, treatment for female sexual dysfunction is becoming routine. Currently, physicians have several options for the treatment of erectile dysfunction (ED) in men. Since the introduction of oral PDE-5 inhibitors, oral therapy has become the first-line treatment option for ED, irrespective of etiology. Currently available treatment options for the female sexual dysfunction include estrogens, androgens, phosphodiesterase inhibitors, and dopamine receptor antagonists. Initial reports regarding the role of early rehabilitation are encouraging and may become the part of routine practice in the management of ED after pelvic surgery. In this article, we summarize the sexual dysfunction following pelvic surgeries and their management. International Journal of Impotence Research (2006) IntroductionErectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. 1 Several factors have been implicated in the etiology of ED. Vascular and neurogenic causes are the most common among them. Diabetes, smoking and hypertension are the most important risk factors for vasculogenic sexual dysfunction. Neurological dysfunction is mainly associated with certain neurological syndromes like autonomic neuropathy. Sexual dysfunction after pelvic surgery has been an important and underreported cause of ED. The pathophysiology of sexual dysfunction after pelvic surgery is unique because it can be either vascular or neurogenic factors alone, or a combination of both. The pelvic surgeries in males that are associated with considerable ED include radical prostatectomy (RP), radical cystoprostatectomy (cystectomy) and low anterior or abdominoperineal resections (APRs) for rectal cancer. The pelvic surgeries in females associated with sexual dysfunction include radical cystectomy (RC) for bladder cancer, radical hysterectomy for cancers of the cervix and endometrium and, potentially, simple hysterectomy for benign tumors.In this article, we summarize male and female sexual dysfunction following pelvic surgeries for prostate, bladder and rectal cancer. We also discuss our experience in the treatment of sexual dysfunction following RP and RC. than 10%, urologists still report that the majority of patients experience ED following RRP. [3][4][5] Until recently, ED following RP was not an overwhelming concern, as most prostate cancers were detected in older men. 6 However, since the adven...

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“…Given the novelty and interest in minimally invasive/ minimal access options, studies comparing the laparoscopic approaches to RRP have been published [5,7,[12][13][14]. Collectively, these reports have improved our understanding of perioperative morbidity and quality-of-life (QoL) differences among treatment approaches.…”

Section: Introductionmentioning

confidence: 99%

“…At present there are several definitive surgical options for managing clinically localized prostate cancer, including radical retropubic prostatectomy (RRP), laparoscopic RP (LRP), and robot-assisted RP (RARP) [1][2][3][4][5][6][7][8][9][10][11][12]. Given the novelty and interest in minimally invasive/ minimal access options, studies comparing the laparoscopic approaches to RRP have been published [5,7,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot‐assisted techniques

et al. 2009

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OBJECTIVETo assess the perioperative complications and early oncological results in a comparative study matching open radical retropubic (RRP) and robot‐assisted radical prostatectomy (RARP) groups.PATIENTS AND METHODSFrom August 2002 to December 2005 we identified 294 patients undergoing RARP for clinically localized prostate cancer. A comparison RRP group of 588 patients from the same period was matched 2:1 for surgical year, age, preoperative prostate‐specific antigen level, clinical stage and biopsy Gleason grade. Perioperative complications were compared. Patients completed a standardized quality‐of‐life questionnaire. Pathological features were assessed and Kaplan‐Meier estimates of biochemical progression‐free survival (PFS) were compared.RESULTSThere was no significant difference in overall perioperative complications between the RARP and RRP groups (8.0% vs 4.8%, P = 0.064). Wound herniation was more common after RARP (1.0% vs none, P = 0.038), and development of bladder neck contracture was more common after RRP (1.2% vs 4.6%; P < 0.018). The hospital stay was less after RARP (29.3% vs 19.4%, P = 0.004, for a stay of 1 day). At the 1‐year follow‐up there was no significant difference in continence (RARP 91.8%, RRP 93.7%, P = 0.344) or potency (RARP 70.0%, RRP 62.8%, P = 0.081) rates. The biochemical PFS was no different between treatments at 3 years (RARP 92.4%, RRP 92.2%; P = 0.69).CONCLUSIONThere was no significant difference in overall early complication, long‐term continence or potency rates between the RARP and RRP techniques. Furthermore, early oncological outcomes were similar, with equivalent margin positivity and PFS between the groups.

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Laparoscopic Versus Open Radical Prostatectomy: A Comparative Study at a Single Institution

Cited by 354 publications

References 18 publications

Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: A comparison of length of sick leave

Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: A comparison of length of sick leave

Sexual dysfunction after pelvic surgery

Radical prostatectomy for prostatic adenocarcinoma: a matched comparison of open retropubic and robot‐assisted techniques

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