ROBOT-ASSISTED LAPAROSCOPIC PROSTATECTOMY: OUR EXPERIENCE

• Main Authors: S. N. Nesterov, V. V. Rogachikov, K. P. Tevlin, A. A. Strat
• Format: Article
• Language: Russian
• Published: ABV-press 2014-08-01
• Series: Onkourologiâ
• Subjects: prostate cancer; robotic da Vinci system; robot-assisted laparoscopic prostatectomy
• Online Access: http://oncourology.abvpress.ru/index.php/oncur/article/view/245
• ISSN: 1726-9776; 1996-1812

<p><strong>Background. </strong>Retropubic radical prostatectomy (RPE) is now the gold standard of treatment for locally advanced prostate cancer (PC). However, robot-assisted RPE procedures using the da Vinci system are finding increasing acceptance.</p><p><strong>Materials and methods. </strong>The authors conducted a prospective study of 60 robot-assisted prostatectomies made at the Clinic of Urology, N.I. Pirogov National Medical Surgical Center, in the period January 2009 to December 2010.</p><p><strong>Results. </strong>The duration of an operation averaged 230 min; the average amount of blood loss was 200 ml. The mean duration of postoperative analgesia was 2,7 days. That of urinary catheterization was 8.5 days. A normal postoperative course was noted in most cases (88,4 %). Seven patients were found to have 8 (13,3 %) mild and moderate complications. A pathohistological study revealed a positive surgical margin of resection in 21,7 % of the patients, extracapsular tumor growth in 21,7 %, and seminal vesicle invasion in 23,3 %. Tumor-affected regional lymph nodes were detected in 1 (1,7 %) patient. In our observed series, 82 and 93 % of the subjects completely retained urine after 6 and 12 moths, respectively. Throughout the follow-up, erectile function recovered in 7 of the 15 patients undergoing a nerve-sparing surgical procedure.</p><p><strong>Conclusion. </strong>Postoperative results in our series of interventions are comparable to those obtained in the studies by Russian and foreign colleagues at the early stage of mastering this procedure. By considering a few observations, it is today difficult to say that our study is valid in the context of evidence-based medicine. Estimation of the benefits of robot-assisted laparoscopic prostatectomy calls for long-term multicenter randomized trials.</p>