R Dotzauer1, A La Torre2, A Thomas2, M P Brandt2, K Böhm2, R Mager2, H Borgmann2, W Jäger2, M Kurosch2, T Höfner2, C Ruckes3, A Haferkamp2, I Tsaur2. 1. Department of Urology, University Medical Center, Johannes Gutenberg University, Mainz, Germany. robert.dotzauer@unimedizin-mainz.de. 2. Department of Urology, University Medical Center, Johannes Gutenberg University, Mainz, Germany. 3. Interdisciplinary Centre for Clinical Trials (IZKS), University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Abstract
PURPOSE: Open simple prostatectomy (OSP) is a standard surgical technique for patients with benign prostatic hyperplasia with prostate size larger than 80 ml. As a minimally invasive approach, robot-assisted simple prostatectomy (RASP) emerged as a feasible surgical alternative. Currently, there are no definite recommendations for the standard use of RASP. Therefore, we aimed at investigating various clinical outcomes comparing RASP with OSP. METHODS: In this retrospective single-center study, we evaluated clinical data from 103 RASP and 31 OSP patients. Both cohorts were compared regarding different clinical characteristics with and without propensity score matching. To detect independent predictive factors for clinical outcomes, multivariate logistic regression analysis was performed. RESULTS: Robot-assisted simple prostatectomy patients demonstrated a lower estimated blood loss and need for postoperative blood transfusions as well as less postoperative complications. OSP had a shorter operative time (125 min vs. 182 min) longer hospital stay (11 days vs. 9 days) and longer time to catheter removal (8 days vs. 6 days). In the multivariate analysis, RASP was identified as an independent predictor for longer operative time, lower estimated blood loss, shorter length of hospital stay, shorter time to catheter removal, less postoperative complications and blood transfusions. CONCLUSION: Robot-assisted simple prostatectomy is a safe alternative to OSP with less perioperative and postoperative morbidity. Whether OSP (shorter operative time) or RASP (shorter length of hospital stay) has a more favorable economic impact depends on the particular conditions of different health care systems. Further prospective comparative research is warranted to define the value of RASP in the current surgical management of benign prostatic hyperplasia.
PURPOSE: Open simple prostatectomy (OSP) is a standard surgical technique for patients with benign prostatic hyperplasia with prostate size larger than 80 ml. As a minimally invasive approach, robot-assisted simple prostatectomy (RASP) emerged as a feasible surgical alternative. Currently, there are no definite recommendations for the standard use of RASP. Therefore, we aimed at investigating various clinical outcomes comparing RASP with OSP. METHODS: In this retrospective single-center study, we evaluated clinical data from 103 RASP and 31 OSPpatients. Both cohorts were compared regarding different clinical characteristics with and without propensity score matching. To detect independent predictive factors for clinical outcomes, multivariate logistic regression analysis was performed. RESULTS: Robot-assisted simple prostatectomy patients demonstrated a lower estimated blood loss and need for postoperative blood transfusions as well as less postoperative complications. OSP had a shorter operative time (125 min vs. 182 min) longer hospital stay (11 days vs. 9 days) and longer time to catheter removal (8 days vs. 6 days). In the multivariate analysis, RASP was identified as an independent predictor for longer operative time, lower estimated blood loss, shorter length of hospital stay, shorter time to catheter removal, less postoperative complications and blood transfusions. CONCLUSION: Robot-assisted simple prostatectomy is a safe alternative to OSP with less perioperative and postoperative morbidity. Whether OSP (shorter operative time) or RASP (shorter length of hospital stay) has a more favorable economic impact depends on the particular conditions of different health care systems. Further prospective comparative research is warranted to define the value of RASP in the current surgical management of benign prostatic hyperplasia.
Authors: Panagiotis Mourmouris; Selcuk M Keskin; Andreas Skolarikos; Omer Burak Argun; Andreas A Karagiannis; Ilter Tufek; Can Obek; Ali Riza Kural Journal: BJU Int Date: 2018-10-15 Impact factor: 5.588
Authors: Christian Gratzke; Boris Schlenker; Michael Seitz; Alexander Karl; Peter Hermanek; Nicholas Lack; Christian G Stief; Oliver Reich Journal: J Urol Date: 2007-04 Impact factor: 7.450
Authors: Riccardo Autorino; Homayoun Zargar; Mirandolino B Mariano; Rafael Sanchez-Salas; René J Sotelo; Piotr L Chlosta; Octavio Castillo; Deliu V Matei; Antonio Celia; Gokhan Koc; Anup Vora; Monish Aron; J Kellogg Parsons; Giovannalberto Pini; James C Jensen; Douglas Sutherland; Xavier Cathelineau; Luciano A Nuñez Bragayrac; Ioannis M Varkarakis; Daniele Amparore; Matteo Ferro; Gaetano Gallo; Alessandro Volpe; Hakan Vuruskan; Gaurav Bandi; Jonathan Hwang; Josh Nething; Nic Muruve; Sameer Chopra; Nishant D Patel; Ithaar Derweesh; David Champ Weeks; Ryan Spier; Keith Kowalczyk; John Lynch; Andrew Harbin; Mohan Verghese; Srinivas Samavedi; Wilson R Molina; Emanuel Dias; Youness Ahallal; Humberto Laydner; Edward Cherullo; Ottavio De Cobelli; David D Thiel; Mikael Lagerkvist; Georges-Pascal Haber; Jihad Kaouk; Fernando J Kim; Estevao Lima; Vipul Patel; Wesley White; Alexander Mottrie; Francesco Porpiglia Journal: Eur Urol Date: 2014-12-04 Impact factor: 20.096
Authors: Simone Scarcella; Daniele Castellani; Vineet Gauhar; Jeremy Yuen-Chun Teoh; Carlo Giulioni; Pietro Piazza; Carlo Andrea Bravi; Ruben De Groote; Geert De Naeyer; Stefano Puliatti; Andrea Benedetto Galosi; Alexandre Mottrie Journal: Investig Clin Urol Date: 2021-11