Robotic Assisted Laparoscopic Radical Prostatectomy ; The Early Result of Patients in Siriraj Hospital, Thailand

Abstract

Introductions: Prostate Cancer is one of the most commonly diagnosed cancer in men. Treatment options and prognosis depend on the stage of the cancer, the Gleason score, the patientûs age and general health. In the patients with clinically localized prostate cancer, Radical Prostatectomy is one of the standard treatment. And laparoscopic approach by robotic assisted has been accepted in many centers around the world. Robotic Assisted Laparoscopic Radical Prostatectomy (RALRP) has been adopted in Siriraj hospital since February 2007.
Objectives: Retrospective study in term of demographic data, perioperative outcomes and postoperative results of patients who underwent RALRP at Siriraj Hospital Bangkok, Thailand since February 2007 - July 2009 was performed to study the perioperative and post operative outcomes.
Material and Methods: A retrospective review of patients with clinically localized and locally-advanced prostate cancer who underwent RALRP in Siriraj hospital between february 2007 to July 2009, All patients were histologic prove adenocarcinoma of the prostate. Patients choose robotic assisted laparoscopic radical prostatectomy for treatment after available options were informed. Demographic data, perioperative data, pathologic data and post operative data were evaluated.
Results: A total number of 357 cases were studied. An average age is 66.89 years old (range = 40-86). Most of clinical presentations are LUTS with high PSA. Their average PSA value is 16.89 ng/ml (range = 1.83-250). 20 patients were treated with hormonal treatment before operation (Neoadjuvant hormonal treatment). The mean operative time and blood loss is 213.20 minutes (range = 90-720) and 471.18 ml (range = 200-2600). Respectively, 27 patients (7.56%) had blood transfusion. Mean hospital stay is 9.19 days (range = 3-40). Perioperative complications occurred in 58 patients (16.24%) which included wound infection, urine leakage, bleeding, pulmonary embolism, UTI and rectal injury. However, there is no perioperative mortality in the series. Pathologically,most of stage is 2b (TMN 2002) and the positive margin rate is 38%
Conclusion: RALRP has already introduced as a viable option of treatment for localized and locallyadvanced prostate cancer in Siriraj hospital. The initial results are encouraging in term of low morbidity. However, The cancer control needs to be improved.