Outcomes over 20 years performing robot-assisted laparoscopic prostatectomy: a single-surgeon experience.
World J Urol
; 41(4): 1047-1053, 2023 Apr.
Article
em En
| MEDLINE
| ID: mdl-36930256
ABSTRACT
OBJECTIVE:
To evaluate a single surgeon's 20-year experience with robotic radical prostatectomy.METHODS:
Patients who had undergone robot-assisted laparoscopic prostatectomy by a single surgeon were identified via an IRB approved prospectively maintained prostate cancer database. Patients were divided into 5-year cohorts (cohort A 2001-2005; cohort B 2006-2010; cohort C 2011-2015; cohort D 2016-2021) for analysis. Oncologic and quality of life outcomes were recorded at the time of follow-up visits. Continence was defined as 0-1 pad with occasional dribbling. Potency was defined as intercourse or an erection sufficient for intercourse within the last 4 weeks.RESULTS:
Three thousand one hundred fifty-two patients met criteria for inclusion. Clavien ≥ 3 complication rates decreased from 5.9% to 3.2%, p = 0.021. There was considerable Gleason grade group (GG) and stage migration to more advanced disease between cohort A (6.4% GG4 or GG5, 16.2% pT3 or pT4, 1.2% N1) and cohort D (17% GG4 or GG5, 45.5% pT3 or pT4, 14.4% N1; p < 0.001). Consistent with this, an increasing proportion of patients required salvage treatments over time (14.6% of cohort A vs 22.5% of cohort D, p < 0.001). 1-year continence rates improved from 74.8% to greater than 92.4%, p < 0.001. While baseline potency and use of intraoperative nerve spare decreased, for patients potent at baseline, there were no significant differences for potency at one year (p = 0.065).CONCLUSIONS:
In this 20-year review of our experience with robotic prostatectomy, complication rates and continence outcomes improved over time, and there was a migration to more advanced disease at the time of surgery.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Próstata
/
Robótica
/
Laparoscopia
/
Procedimentos Cirúrgicos Robóticos
/
Cirurgiões
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Humans
/
Male
Idioma:
En
Revista:
World J Urol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos