Comparative study of laparoscopic radical prostatectomy and robot‐assisted radical prostatectomy on perioperative, oncological and functional outcomes

摘要

Aim The aim of the present study was to evaluate the perioperative, oncological and functional outcomes of laparoscopic radical prostatectomy (LRP) and robot‐assisted radical prostatectomy (RARP) performed at our centres. Patients and Methods All LRP and RARP performed from January 2011 to June 2016 were reviewed through electronic patient records. The preoperative cancer characteristics, perioperative parameters, pathology, oncological and functional outcomes were studied. Results A total of 136 men were included in the analysis. RARP had a significantly less estimated blood loss (933 mL vs 361 mL, P < 0.01) than LRP. Positive surgical margins were noted in 42.6 and 35.2 per cent for LRP and RARP. Four‐year biochemical recurrence‐free survival was 79.4 per cent. There were no difference across the two groups. The 3‐, 12‐, 24‐ and 36‐month continence rates were 51.6, 86.8, 86.6 and 84.6 per cent, respectively. Early continence was better in RARP. The Urogenital Distress Inventory‐6 was significantly lower for RARP at 6 weeks and 3 and 12 months, while the Incontinence Impact Questionnaires‐7 was lower for RARP at 6 weeks and at 3 months. The 3‐, 12‐, 24‐ and 36‐month erection sufficient for intercourse (ESI) rates were 11.6; 25.5; 28.4 and 21.4 per cent, respectively. More men achieved ESI after 12 months in RARP. The International Index of Erectile Function 5‐item version score was higher in RARP from 12 months onwards. Conclusion RARP appears to be a promising approach for greater minimally‐invasive benefit and functional outcome, without jeopardizing oncological control.