Robot-Assisted Laparoscopic Radical Prostatectomy – early results after 65 cases
H.Logigan, V. Ona, F. Dobrota, Z. Mihaly, N. Crisan, I. Coman
Robotic Surgery Centre – County Clinical Hospital Cluj – Napoca, Romania
Introduction & Objectives:
The screening for prostate cancer (PC) by PSA testing increased the diagnosed number of localized PCs. These localized forms qualify for minimal invasive methods such as Robot-Assisted Laparoscopic Radical Prostatectomy (RALP). Our aim is to evaluate the surgical technique and the oncological and functional results after 65 RALPs, in a surgical center with experience in laparoscopic surgery.
Material & Method:
Between November 2009 and February 2012 65 RALPs were performed at Clinical Municipal Hospital from Cluj-Napoca. Regarding the surgical technique we assessed: the mean operative time, the mean blood loss and the rate of surgical complications using the modified Clavien-Dindo system. We prospectively evaluated at 1, 3 and 6 months the oncological (positive margins, PSA recurrence) and functional results (continence and erectile function).
Results:
The mean operating time for the entire procedure was 240 minutes (with a mean console time of 180 minutes). The mean blood loss was 160 ml. Minor complications occurred in 21,5% of patients (Clavien 1: 20%; Clavien 2: 1,5%); fever requiring antipyretics dominated (13,84%). Thirty-eight (59%) patients were staged pT2 and 27 (41%) pT3. Positive margins were obtained in 25 (38,4%) patients, of which 17 (26%) were pT3, and 8 (12,4%) pT2. Eight patients had biochemical relapse of the disease. Forty-one (63%) patients were continent at 1 month (needed 1 pad/day, or less), 51 (78%) patients at 3 months, and 59 (90%) patients at 6 months after surgery.Fifty patients were sexually active preoperative, of which 22 (44%) had recovered the erectile function at 3 months after surgery.
Conclusions:
RALP is a minimally invasive method of treatment in prostate cancer, providing good oncological results while maintaining the functional outcomes (continence, erectile function). RALP is an easy to assess technique, with good results for a surgical team with experience in laparoscopic prostatectomy.