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BJU Int. 2011 Apr;107 Suppl 3:11-9. doi: 10.1111/j.1464-410X.2011.10053.x.

Perioperative, functional and oncological outcomes after open and minimally invasive prostate cancer surgery: experience from Australasia.

Author information

  • 1Department of Urology, Royal Melbourne Hospital, Melbourne, Australia. pjcathcart@hotmail.com

Abstract

OBJECTIVE:

•  To systematically review the current literature concerning perioperative, functional and oncological outcomes reported after open and minimally invasive prostate cancer surgery specifically from institutions within Australasia.

MATERIALS AND METHODS:

•  Four electronic databases were searched to identify studies reporting outcome after open and minimally invasive prostate cancer surgery. Studies were sought using the search term 'radical prostatectomy'. •  In all, 11,378 articles were retrieved. For the purpose of this review, data were only extracted from studies reporting Australasian experience. •  A total of 28 studies met final inclusion criteria.

RESULTS:

•  Overall, the data are limited by the low methodological quality of available studies. •  Only two comparative studies evaluating open radical prostatectomy (ORP) and robotic-assisted laparoscopic RP (RALP) were identified, both non-randomized. •  The mean blood loss, catheterization time and hospital stay was shorter after RALP than with ORP. In contrast, mean operative procedure time was significantly longer for RALP. •  Overall adverse event rates were similar for the different surgical approaches although the rate of bladder neck stricture was significantly higher after open RP. •  Incorporation of patient outcomes achieved by surgeons still within their learning curve resulted in a trend towards higher positive surgical margin rates and lower continence scores after RALP. However, there was equivalence once the surgeons' learning curve was overcome. Given the limited follow-up for RALP and laparoscopic RP (14.7 and 6 months vs 43.8 months for ORP) and the lack of data concerning erectile function status, comparison of biochemical failure and potency was not possible.

CONCLUSIONS:

•  Few comparative data are available from Australasia concerning open and minimally invasive prostate cancer surgery. •  While perioperative outcomes appear to favour minimally invasive approaches, further comparative assessment of functional and long-term oncological efficacy for the different surgical approaches is required to better define the role of minimally invasive approaches.

© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

PMID:
21492370
[PubMed - indexed for MEDLINE]
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