OBJECTIVE: Radical prostatectomy (RP) is an oncologic and functional challenge.
Few series compare prospectively the two approaches, open retropubic (ORP) and laparoscopic robot-assisted RP (LRARP). The objective was to compare the oncological and functional results of ORP and LRARP.
MATERIAL AND METHODS: From January 2009 to March 2012, two practiced surgeons conducted 304 consecutive RP: respectively 129 ORP and 175 LRARP. Preoperative, perioperative and postoperative data (location and size of positive surgical margins [PSM]) were recorded prospectively and compared with oncological results (PSM, biochemical recurrence-free survival [BCR]) and functional outcomes (urinary and erectile) by self-validated questionnaires (USP, IIEF-15). The comparison was made by the Chi2 test and Student t-test for qualitative and quantitative variables.
RESULTS: The preoperative data 2 groups were comparable. MCP rate was 13.2% for the ORP and 20% for the LRARP (ns) and was 1.4% and 29.6% (ORP) versus 9.4% and 36.7% (LRARP) for pT2 and pT3 for respectively (P=0.078). BCR was the same in both groups (95.2% at 13.1 months). At 12months, the results of continence showed no difference (P=0.49) and about erectile function, the EF-score was significantly higher in LRARP: 22 versus 17 for the ORP (P=0.03).
CONCLUSION: Oncological results were comparable after ORP and LRARP. The recovery of continence was excellent regardless of the surgical technique, the recovery of erectile function a bit faster by LRARP.
Written by:
Beauval JB, Roumiguié M, Ouali M, Doumerc N, Thoulouzan M, Mazerolles C, Rischmann P, Malavaud B, Soulié M. Are you the author?
Département d'urologie, andrologie et transplantation rénale, CHU Rangueil, 1, avenue Jean-Pouilhès, 31059 Toulouse cedex, France; Département d'études statistiques, IUC Oncopôle, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; Département d'anatomopathologie, IUC Oncopôle, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
Reference: Prog Urol. 2015 Jun;25(7):370-8.
doi: 10.1016/j.purol.2015.03.007
PubMed Abstract
PMID: 25937373
Article in French.