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Comparative investigation on clinical outcomes of robot‐assisted radical prostatectomy between experienced open prostatic surgeons and novice open surgeons in a laparoscopically naïve center with a limited caseload
Author(s) -
Sumitomo Makoto,
Kanao Kent,
Kato Yoshiharu,
Yoshizawa Takahiko,
Watanabe Masahito,
Zennami Kenji,
Nakamura Kogenta
Publication year - 2015
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12711
Subject(s) - prostatectomy , medicine , laparoscopic radical prostatectomy , urology , perioperative , single center , surgery , prostate , cancer
Objectives To compare perioperative, oncological and functional outcomes of robot‐assisted radical prostatectomy between experienced and novice open radical prostatectomy surgeons in a laparoscopically naïve center with a limited caseload. Methods Six surgeons carried out robot‐assisted radical prostatectomy in 154 patients, which were divided into the following three groups: group 1 ( n = 90), including patients operated on by a surgeon with experience in both open radical prostatectomy and robot‐assisted radical prostatectomy; group 2 ( n = 36), including patients operated on by two surgeons with experience in open radical prostatectomy only; and group 3 ( n = 28), including patients operated on by three surgeons with limited experience in both open radical prostatectomy or robot‐assisted radical prostatectomy. Results Groups 2 and 3 did not differ significantly in their median values of external blood loss ( P = 0.165) or console time ( P = 0.103). Positive surgical margin rates for pT2 patients were also similar in these two groups: 21.2% (7/33) in group 2 and 22.7% (5/22) in group 3 ( P = 0.894). Kaplan–Meier analysis showed that 12 months after robot‐assisted radical prostatectomy the prostate‐specific antigen‐free rate for pT2 patients was 96.0% in group 2 and 100% in group 3, but the pad‐free continence rate was just 91.0% in group 1, 88.0% in group 2 and 75.5% in group 3 (group 1 vs group 3, P = 0.037; group 2 vs group 3, P = 0.239). The major complication rate after robot‐assisted radical prostatectomy was 3.3% (3/90) in group 1, 11.1% (4/36) in group 2 and 17.9% (5/28) in group 3 (group 1 vs group 3, P = 0.008; group 2 vs group 3; P = 0.441). Conclusions Robot‐assisted radical prostatectomy offers satisfactory postoperative outcomes even when carried out by surgeons with limited experience in open radical prostatectomy.