Assist. Prof. Dr. Nicolae Crisan
In Romania, the implementation of robotic radical prostatectomy is limited, the difficulties to extend this type of surgery being mostly financial: the limited access of the hospitals to this type of technology and also the high costs of every procedure. Benefitting from a regional prostate cancer screening programme, the Robotic Urology Centre in Cluj-Napoca had the oportunity of implementing the robotic radical prostatectomy as a therapeutical standard in Romania.
Between November 2009 and April 2013, 190 patients with localised and locally-advanced prostate cancer underwent robotic assisted radical prostatectomy at the Robotic Surgery Center of Cluj Napoca County Hospital The rate of positive surgical margins was 24.1% (p=0.0001): 4 patients in pT2c stage, 4 patients in pT3a stage and 6 patients in pT3b stage (p=0.01). There was no statistically significant correlation between the positive margins and the PSA level preoperatively, BMI, clinical stage and type of nerve sparing. The localisation of positive margins correlated with the pathological stage and the number of positive biopsies. At 24 months follow-up, the biochemical recurrence rate was 9.1% (p=0.0001). The rate of postoperative erections was 36.4% at 1 month follow-up and 56.2% at 6 months follow-up. The age of the patient at the moment of the surgical procedure represents a predictive factor for the recovery of sexual function. Continence rate assessed at 1, 6 and 24 months postoperatively was 54.5%, 72.7% and 87% (p=0.001).