Comparison of surgical approaches to radical prostatectomy in our series beyond oncological and functional outcomes.
Actas Urol Esp (Engl Ed)
; 46(5): 275-284, 2022 06.
Article
em En, Es
| MEDLINE
| ID: mdl-35260370
ABSTRACT
OBJECTIVES:
To evaluate the outcomes of robot-assisted radical prostatectomy (RARP) compared to those of open (ORP) and laparoscopic (LRP) surgery. The interest lies fundamentally in the quality-of-life (QoL) evaluation, postoperative recovery, and personal satisfaction of patients with the intervention (PS) beyond oncological and functional outcomes.METHODS:
Six hundred eighty-five RPs were performed in our center between 2011-2018 (17,8% ORP, 22,2% LRP and 60% RARP). Patients were prospectively assessed through follow-up until April 2020 and a multiple questionnaire at 12-months post-RP that included ICIQ-SF, SHIM, IPSS, IQL and questions about pain, postoperative recovery and PS. Also baseline and postoperative patient- and treatment-related data were collected, and binomial logistic regressions were performed for the 1 vs.1 comparisons (ORP vs. RARP and LRP vs. RARP).RESULTS:
RARP patients have overall fewer comorbidities, less tumor aggressiveness, more operative time requirements and more positive surgical margins than ORP and LRP patients. Nevertheless, RARP outperforms ORP in hospital stay (days) (OR 0,86; 95% CI 0,80-0,94), hemoglobin loss (OR 0,38; 95% CI 0,30-0,47), transfusion rate (OR 0,18; 95% CI 0,09-0,34), early complications (pâ¯=â¯0,001), IQL (OR 0,82; 95% CI 0,69-0,98), erectile function (OR 0,41; 95% CI 0,21-0,79), pain control (OR 0,82; 95% CI 0,75-0,89), postoperative recovery (pâ¯<â¯0,001) and choice of a different approach (OR 5,55; 95% CI 3,14-9,80). RARP is superior to LRP in urinary continence (OR 0,55; 95% CI 0,37-0,82), IPSS (OR 0,96; 95% CI 0,93-0,98), IQL (OR 0,76; 95% CI 0,66-0,88), erectile function (OR 0,52; 95% CI 0,29-0,93), postoperative recovery (pâ¯=â¯0,02 and 0,004), PS (pâ¯=â¯0,005; 0,002; and 0,03) and choice of a different approach (OR 7,79; 95% CI 4,63-13,13).CONCLUSIONS:
The findings of our study globally endorse a positive effectiveness of RARP over ORP and/or LRP, both on functional issues, postoperative recovery, QoL and PS. Oncologic results should still be improved.Palavras-chave
Calidad de vida; Laparoscopic radical prostatectomy; Postoperative recovery; Prostatectomía radical asistida por robot; Prostatectomía radical laparoscópica; Prostatectomía radical retropúbica; Quality of life; Recuperación postoperatoria; Retropubic radical prostatectomy; Robot-assisted radical prostatectomy
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Robóticos
/
Disfunção Erétil
Tipo de estudo:
Etiology_studies
Limite:
Humans
/
Male
Idioma:
En
/
Es
Revista:
Actas Urol Esp (Engl Ed)
Ano de publicação:
2022
Tipo de documento:
Article