Hong Kong Med J 2010;16:31–5 | Number 1, February 2010
Short-term outcome of patients with robot-assisted versus open radical prostatectomy: for localised carcinoma of prostate
KL Lo, CF Ng, Cleo NY Lam, Simon SM Hou, KF To, Sidney KH Yip
Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
OBJECTIVE. To compare the short-term outcome of patients undergoing robot-assisted versus open radical prostatectomy.
DESIGN. Retrospective analysis of prospectively collected data.
SETTING. A university teaching hospital in Hong Kong.
PATIENTS. Twenty consecutive cases having robot-assisted radical prostatectomy were compared with the last 20 cases of open radical prostatectomy (prior to November 2005 when the robotic system was introduced).
MAIN OUTCOME MEASURES. Perioperative functional evaluation (with special emphasis on continence) and oncological evaluation (included margin studies and prostate-specific antigen levels).
RESULTS. Regarding baseline clinical characteristics of the patients, there was no statistically significant difference between the robotic and open radical prostatectomy groups. For perioperative outcome, in the robotic group the blood transfusion rate was significantly lower (5 vs 65%), hospital stay was shorter (8 vs 17 days), and the catheter time was shorter (12 vs 18 days). For early oncological outcome, there was no statistically significant difference in the margin positive rate and early prostate-specific antigen results. Regarding continence (use of 0-1 pads/day), it was achieved by 95% in the robotic group with a mean follow-up of 6 months compared to 85% in the open group with a mean follow-up of 42 months.
CONCLUSIONS. Robot-assisted radical prostatectomy offered the benefits of a minimally invasive operation with less blood loss, shorter catheter time and hospital stay, and earlier continence. It has therefore become the preferred surgical option in our institution.
Key words: Prostate-specific antigen; Prostatectomy; Prostatic neoplasms; Robotics; Treatment outcome
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