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Clinical outcomes and costs of robotic surgery in prostate cancer: a multiinstitutional study in Korea

 Ji Eun Yun  ;  Na Rae Lee  ;  Cheol Kwak  ;  Koon Ho Rha  ;  Seong Il Seo  ;  Sung-Hoo Hong  ;  Young Goo Lee  ;  Dong Ah Park  ;  Choung Soo Kim  ;  Seon Heui Lee 
 PROSTATE INTERNATIONAL, Vol.7(1) : 19-24, 2019 
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ASA ; American Society of Anesthesiologists ; BMI ; body mass index ; EBL ; estimated blood loss ; LRP ; laparoscopic radical prostatectomy ; Laparoscopic prostatectomy ; PLND ; pelvic lymph node dissection ; PSA ; prostate-specific antigen ; Prostate cancer ; RALP ; robot-assisted laparoscopic radical prostatectomy ; RRP ; retropubic radical prostatectomy ; Radical prostatectomy ; Robotic prostatectomy ; Robotic surgery
Background: This study compared the surgical, functional, and oncologic outcomes of robot-assisted laparoscopic radical prostatectomy (RALP), laparoscopic radical prostatectomy (LRP), and retropubic radical prostatectomy (RRP) in Korean men. Methods: The study population included 864 patients who underwent radical prostatectomy for prostate cancer in the departments of urology of five tertiary hospitals between 2010 and 2011. RALP, LRP, and RRP perioperative, oncological, and functional outcomes as well as complications were assessed. Medical cost data were analyzed for 682 of 864 patients. Results: No significant differences were found among the three groups regarding the length of stay, biochemical recurrence, complications, and metastasis. The RALP group had a significantly higher rate of pelvic lymph node dissection (64.6% vs. 35.3% or 53.3%, P value <0.0001) and bilateral nerve-sparing procedures (15.7% vs. 10.0% or 8.9%, P value <0.0001) and less blood loss (median 250 mL vs. 300 mL or 700 mL, P value <0.0001) than the LRP and RRP groups. The 12-month continence recovery rate was higher in the RALP group (92.1%) than in the LRP (86.5%) and RRP (84.4%) groups (P value <0.0001). Medical costs for RALP were approximately twofold to threefold higher than those for LRP or RRP. Conclusions: Our findings suggest that surgical and functional outcomes are better with robot-assisted surgery than with laparoscopic or open surgery in terms of estimated blood loss and urinary continence; however, no differences were found among groups in terms of biochemical recurrence and the rate of complications.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
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