Abstract
Aim
Robot-assisted simple prostatectomy (RASP) is a minimally invasive alternative to open simple prostatectomy in the management of patients with large prostate glands suffering from moderate-to-severe lower urinary tract symptoms (LUTS). Our study aimed to evaluate two transvesical robotic approaches in order to compare functional outcomes and postoperative complications.
Materials and methods
Clinical data from 111 consecutive patients from three tertiary robotic centers were retrospectively collected. Patients were divided into two groups depending on the surgical approach: 58 Retzius sparing and 53 Retzius approach RASP. We evaluated peri-operative outcomes (operating time, blood loss, transfusion rate, length of hospital stay), as well as intra-operative and early complications using a Clavien Dindo scale. Fisher’s exact test, chi-square test and Mann–Whitney U test were applied for statistical analyses. A p-value <0.05 was considered statistically significant.
Results
Neither subgroup differed significantly in age (p = 0.104), Charlson comorbidity index (p = 0.088) or prostate volume (p = 0.507), total IPSS score (0.763) and Qmax (p = 0.651). Total complication rates were lower for the Retzius approach subgroup (19 vs 11.9%) without reaching statistical significance in multivariate analysis (HR = 1.21, 95% CI = 0.17 − 8.44, p = 0.84). No significant differences based on IPSS total score and Qmax could be observed between the two subgroups during follow-up.
Conclusions
Both RASP approaches provide similar results in terms of functional outcomes and present a good safety profile in the management of large prostatic adenomas. Larger trials are needed in order to establish the indications for each robotic technique.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The present study is a retrospective one; for this type of study formal consent is not required.
Author contributions
Study conception and design: Surcel, Labanaris, Zugor. Sinescu, Gandaglia, A. Kretschmer, Mirvald
Acquisition of data: Najjar, Labanaris, Zugor, Kajaia, Heidegger, Kretschmer, Mirvald
Analysis and interpretation of data: Surcel, Labanaris, Heidegger, Gandaglia, Kretschmer, C. Mirvald
Drafting of manuscript: Surcel, Najjar, Labanaris, Kajaia, Heidegger, Sinescu, Gandaglia, Kretschmer, Mirvald
Critical revision: Surcel, Zugor, Heidegger, Sinescu, Gandaglia, Kretschmer, Mirvald
Disclosure statement
No potential conflict of interest was reported by the author(s).