Perioperative outcomes of robotic-assisted laparoscopic radical prostatectomy, laparoscopic radical prostatectomy and open radical prostatectomy: 10 years of cases at Ramathibodi Hospital

Abstract

Background: This study aims to compare the perioperative and pathological outcomes of open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robotic-assisted laparoscopic radical prostatectomy (RALRP) at Ramathibodi Hospital within Mahidol University in Thailand.Methods: From January 2008 to July 2017, 679 RPs were performed. Patients' data were collected retrospectively to evaluate their perioperative and pathological outcomes. This data included the age, body mass index (BMI), serum prostate specific antigen (PSA) level, clinical stage, Gleason score (GS) from biopsy, operative time, estimated blood loss (EBL), perioperative complications, blood transfusion rate, adjacent organ injury rate, length of hospital stay, pathological stage, GS of the biopsy specimen, specimen weight (g), and marginal status of the patients.Results: Of the 679 RPs performed, 128 (19.28%) were ORPs, 241 (36.30%) were LRPs, and 295 (44.43%) were RALRPs. Patients who underwent a RALRP had a significant advantage in EBL (1,600, 500, and 300 mL for ORPs, LRPs, and RALRPs, respectively), overall complications, and blood transfusion rate. As they are minimally invasive techniques, LRP and RALRP presented an advantage in terms of the length of hospital stay (an average of 9, 6, and 6 days for ORPs, LRPs, and RALRPs, respectively) and adjacent organ injury rate. ORPs also had the shortest operative time (160, 210, and 200 min for ORPs, LRPs, and RALRPs, respectively). However, the specimen weight and marginal status were similar in all of the techniques.Conclusions: Minimally invasive RP techniques, such as LRPs and RALRPs, appear to be safe, have significantly better perioperative outcomes than ORPs, and have comparable pathological outcomes to those of ORPs.

Single‐port robot‐assisted radical prostatectomy: a systematic review and pooled analysis of the preliminary experiences

“…Our findings are in line with the most recent series published in high-volume centres using the da Vinci multiport system [24][25][26], especially centres in the USA where the patients were usually discharged with catheter in place. Considering that the results reported with regard to use of the SP platform derived from highly experienced in use multiport system before to approach SP, these data show that the transition from multiport to SP seems to be easy and fast.…”

Single-Port Robot-Assisted Radical Prostatectomy: Where Do We Stand?

“…However, different surgical approaches among surgeons might have represented a major source of bias. Notwithstanding these limitations, results are in line with previously reported outcomes for multi-port radical prostatectomy (MP RALP) [ 37 , 38 , 39 ].…”

Anesthetic Implications of Robotic-Assisted Radical Prostatectomy in a Patient with Immune Thrombocytopenia: a Case Report

“…2 Compared to a tertiary hospital in Thailand with an experience of nearly 700 cases, our first operation took 160 minutes longer and incurred 200 ml more of blood loss; however, the length of hospital stay was equal. 10 More, we remain confident that more experience will enhance our team's surgical performance related to this procedure and help reach the learning curve plateau.…”