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Robotic laparoscopic versus open radical retropubic prostatectomy: comparison of positive surgical margin rate by a single surgeon
Author(s) -
VAN APPLEDORN S.,
BOUCHIERHAYES D.M.,
O'MALLEY P.J.,
KHAIRA H.,
COSTELLO A.J.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06085_60.x
Subject(s) - medicine , surgical margin , radical retropubic prostatectomy , stage (stratigraphy) , surgery , prostatectomy , cohort , resection margin , pathological staging , laparoscopic radical prostatectomy , robotic surgery , laparoscopy , pathological , urology , cancer , prostate cancer , resection , paleontology , biology
A non‐laparoscopically trained genitourinary surgeon began performing robotic‐assisted laparoscopic radical prostatectomies (RLRP) in December, 2003 using the da Vinci (Intuitive Surgical Sunnyvale, CA) robotic system. It remains unclear if RLRP offers a similar degree of cancer control to open radical retropubic prostatectomy (RRP). We examined the pathological outcomes of patients who underwent RLRP and compare them to a similar cohort who previously underwent RRP by the same surgeon. Materials and Methods: Two consecutive patients who underwent RLRP from December, 2003 to April, 2005 were analysed. Their age, PSA, pathological stage and margin status were prospectively collected. 102 consecutive patients who underwent RRP from April 1999 to November 2003 were used for comparison. Results: The mean age of RLRP patients was 60.7 (range 47–73) and their mean PSA was 7.78 (1.3–21.2). Thirteen patients were stage pT3a while the remaining 89 were pT2. Fourteen patients (13.7%) had foci of adenocarcinoma at the inked surgical margin. The RRP patients had a mean age of 59.3 (45–72) and a mean PSA of 9.9 (0.9–37.6). Four patients were pathologic stage T3b, 29 patients were pT3a, and the remaining 69 were pT2. 27 RRP patients (26.4%) had tumour present at the inked margin of surgical resection. Conclusion: RLRP can be successfully performed by a laparoscopic naïve surgeon. The surgical margin status of RLRP patients is better than a cohort treated with RRP by the same surgeon. It will require further analysis to verify if this corresponds with improved recurrence‐free rates, but initial results are promising.