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Background: Robotics assisted laparoscopic prostatectomy (RALRP) has been shown to improve functional outcomes when compared to open or laparoscopic prostatectomy with similar oncologic results. It has become a famous procedure for treating patients with localized prostate cancer. The program of RALRP has just been started at Ramathibodi Hospital for about a year. The feasibility of this procedure in our institution has to be established.
Objective: To evaluate the feasibility of the RALRP that was performed early at Ramathibodi Hospital.
Methods: Medical records of 30 patients with clinically localized prostate cancer who underwent RALRP by two laparoscopic-experienced urologists in Ramathibodi Hospital from May 2013 to January 2014 were retrospectively reviewed including outcomes, complications, and cost per admission for RALRP.
Results: Mean operative time was 4.2 hours (range 2.0 – 7.3) and mean estimated blood loss was 527 mL (range 100 – 2200) without blood transfusion requirement in 80% of all patients. There were no intraoperative complications and no conversions to open surgery. Twenty-four patients (80%) had pT2 disease and 6 patients had pT3 disease. Positive surgical margin rate was 53%. There were 20% minor post-operative complications, and no major post-operative complications and mortalities. Mean length of hospital stay was 8 days (range 5 - 19) and mean duration of urethral catheter indwelling was 11 days (range 5 – 22). Mean post-operative serum PSA level was 0.08 ng/mL (range 0.00 - 1.12) with mean follow-up duration of 86 days. Total cost per admission for RALRP was 126,875 baht (range 50.968 - 343,027)
Conclusions: RALRP for prostate cancer in Ramathibodi Hospital is safe but additional studies are needed to indicate the feasibility of this procedure.
Khuhaprema T. Current cancer situation in Thailand. Thai J Toxicology. 2008;23:60-61.
Heidenreich A, Bastian PJ, Bellmunt J, et al. EAU guidelines on prostate cancer. part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol. 2014;65(1):124-137. doi:10.1016/j.eururo.2013.09.046.
Lowrance WT, Parekh DJ. The rapid uptake of robotic prostatectomy and its collateral effects. Cancer. 2012;118(1):4-7. doi:10.1002/cncr.26275.
Berryhill R Jr, Jhaveri J, Yadav R, et al. Robotic prostatectomy: a review of outcomes compared with laparoscopic and open approaches. Urology. 2008;72(1):15-23. doi:10.1016/j.urology.2007.12.038.
Rocco B, Matei DV, Melegari S, et al. Robotic vs open prostatectomy in a laparoscopically naive centre: a matched-pair analysis. BJU Int. 2009;104(7):991-995. doi:10.1111/j.1464-410X.2009.08532.x.
Ficarra V, Novara G, Ahlering TE, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):418-430. doi:10.1016/j.eururo.2012.05.046.
Novara G, Ficarra V, Mocellin S, et al. Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):382-404. doi:10.1016/j.eururo.2012.05.047.
Yossepowitch O, Briganti A, Eastham JA, et al. Positive surgical margins after radical prostatectomy: a systematic review and contemporary update. Eur Urol. 2014;65(2):303-313. doi:10.1016/j.eururo.2013.07.039.