Original Article. Open Retropubic and Robot-Assisted Radical Prostatectomy in Prostate Carcinoma: Advantages of Methods
Nikolay H. Kolev
, Jitian A. Atanasov
, Vladislav R. Dunev
, Boyan A. Stoykov
, Rumen P. Kotsev
, Alexander Vanov
, Fahd Al-Shargabi
, Pencho T. Tonchev
, Sergey D. Iliev
, and Toni I. Stoyanov
1 Clinic of Urology, University Hospital – Pleven 8a, G. Kochev Blvd. Pleven, 5800, Bulgaria
2 Department of Urology, Medical University – Pleven, Bulgaria
3 Department of Surgery, Medical University – Pleven, Bulgaria
4 Department of General Surgery, General Hospital of Villarobledo, Spain
Prostate cancer (PC) is the most common type of cancer in men inanumber of countries. The choice of surgical technique for radical prostatectomy (RP) concerns both patients and urologists. The choice is not easy to make, since data is still limited due to the lack of large multicentric randomized research trials. For three years (2011-2014), 244 patients with limited prostate cancer were operated in the Urology Clinic of the University Hospital in Pleven. Robot-assisted radical prostatectomy (RARP) was performed on 35 patients (14%), open retropubic radical prostatectomy (ORP) - on 199 patients (81%), and laparoscopic RP - on 12 patients (5%). The preoperative and post-op results from the first two groups were compared. For the follow-up period of 12 months, functional results in 82 patients of the ORPgroup were compared to the results in the 35 patients of the RARPgroup. The operative time was significantly longer in the RARPgroup, and blood loss was lower. The catheter stay was shorter in patients with RARP. The percentage of significant postoperative complications was 0%in the patients with RARPand 3%in the patients with an ORP. RARPpatients demonstrated better continence: 91%vs. 87%and erectile function46%vs.40%at 12 months.
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1. Zhou CK, Check DP, Lortet-Tieulent J, Laversanne M, Jemal A, Ferlay J, et al. Prostate cancer incidence in 43 populations worldwide: An analysis of time trends overall and by age group. Int J Cancer. 2016;138(6):1388-400.
2. Albertsen PC. Robot-assisted radical prostatectomy - fake innovation or the real deal? Eur Urol. 2012;62(3):365-7.
3. Montorsi F, Wilson TG, Rosen RC, Ahlering TE, Artibani W, Carroll PR, et al. Best practices in robot-assisted radical prostatectomy: Recommendations of the Pasadena consensus panel. Eur Urol. 2012;62(3):368-81.
4. Smith JA, Herrell SD. Robotic-assisted laparoscopic prostatectomy: do minimally invasive approaches offer significant advantages? J Clin Oncol. 2005;23(32):8170-5.
5. Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy:asystematic review and cumulative analysis of comparative studies. Eur Urol. 2009;55(5):1037-63.
6. Ficarra V, Novara G, Fracalanza S, D'Elia C, Secco S, Iafrate M, et al.Aprospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int. 2009;104(4):534-9.
7. Novara G, Ficarra V, Rosen RC, Artibani W, Costello A, Eastham JA, et al. Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):431-52.