OUR EARLY EXPERIENCE WITH ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY - FIRST 153 CASES
Authors:
Jan Doležel 1,2; Jaroslav Tvarůžek 2; Michal Staník 1; Radek Zachoval 2; Igor Šimoník 2; Milan Korsa 2; Václav Vagunda 3
Authors place of work:
Robotické centrum Vysočina, Nemocnice sv. Zdislavy a. s., Velké Meziříčí
1; Masarykův onkologický ústav, oddělení onkourologie, Brno
2; Cedelab s. r. o., oddělení patologie, Velké Meziříčí
3
Published in the journal:
Ces Urol 2009; 13(2): 168-177
Category:
Original article
Summary
Aim:
We present our early experience with the robot-assisted laparoscopic radical prostatectomy (RALP) in one of the four centres of robotic surgery in the Czech Republic.
Material and methods:
In the period from 1. 5. 2007 till 30. 9. 2008 we performed 153 RALP using 3 armed Da Vinci system (Intuitive surgical) in the centre of robotic surgery Vysočina. Th e operation was indicated mainly in patients with the clinically localized prostate cancer, stage cT1c was identified in 78.1%, in 20% cT2 and we operated only two patients (1.5%) with locally advanced disease. Th e mean prostate-specific antigen (PSA) value was 7.2 ng/ml (2–19 ng/ml). Preoperative Gleason score (GS) 6 or less was found in 69.3% patients, GS 7 in 27.1% and GS 8–10 in 3.6% patients. Th e average age of the patients was 63 years. In this study we evaluate operating time, blood loss, perioperative and late complications, definitive histopathology and functional outcomes. Th e mean followup is 8.5 months.
Results:
Th e mean operative skin-to-skin time was 148 (72–540) minutes and the blood loss averaged 329 (50–1500) ml. Th e pT2 stage was diagnosed in 52% and pT3 in 48% of the patients. Positive surgical margins were described in 18.7% overall, 13.6% in pT2 subgroup and 24.6% in pT3. Th e complication rate was 15% with no mortality. Patients were discharged by the fourth postoperative day in 84%. Th e catheter was removed between 8.–14. day if the postooperative course was uneventful. Immediately aft er catheter removal 25% of the patients were fully continent (0–1 pad/day), six months later in 92%. Biochemical relaps was noted in 9.2 % of the cases.
Conclusions:
Our study confirms the feasibility and safety of robot-assisted laparoscopic radical prostatectomy. It is possible to attain promising oncological and functional outcomes in a short period of time, despite of lack of experience of the operating team.
Key words:
prostate cancer, robot-assisted laparoscopic radical prostatectomy.
Zdroje
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Štítky
Paediatric urologist Nephrology UrologyČlánok vyšiel v časopise
Czech Urology
2009 Číslo 2
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- OUR EARLY EXPERIENCE WITH ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY - FIRST 153 CASES