Clinical outcome comparison of retropubic radical prostatectomy and standard laparoscopic radical prostatectomy / 中华泌尿外科杂志

ABSTRACT

Objective To compare the clinical outcome between open retropubic radical prostatectomy (RRP) and standard laparoscopic radical prostatectomy (SLRP).Methods From January,2008 to December,2014,643 cases of RRP and 161 cases of SLRP were retrospectively reviewed.No significant difference was found in age,body mass index,preoperative prostate specific antigen and pathological results of biopsy between the 2 groups (P ＞ 0.05).The operating time,blood loss,transfusion rate,hospital stay,positive surgical margin rate,urine leakage rate,urethra stricture rate,urinary continence recovery at 6 months and 12 months,2-year biochemical recurrence and median biochemical recurrence of the 2 groups were compared.Results The mean operating time was 131.6 ± 34.5 min in RRP group while 171.3 ±35.1 min in SLRP group (P =0.000).The blood loss was 385 ± 142 ml in RRP group and 194±87 ml in SLRP group (P =0.000),respectively.For the transfusion rate,the RRP group was 3.4％ (22/643) while the SLRP group was 2.5 ％ (4/161),there was no significant difference between the 2 groups (P =0.548).The urine leakage rates were 12.8％ (82/643) in RRP group and 6.2％ (10/161) in SLRP group (P =0.020).The average hospital stay in SLRP group was 6.7 ± 1.5 d,which was significantly shorter than 7.5 ± 1.3 d in RRP group (P =0.000).A pad-free continence was achieved in 68.7％ (442/643) of the cases in RRP group and in 78.9％ (127/161) of the cases in SLRP group at 6 months after surgery (P =0.011).However,there was no significant difference in pad-free continence between the 2 groups at 12 months after surgery (P =0.376).In RRP group,complete continent rate was 94.6％ (608/643),while in SLRP group,it was 96.3％ (155/161).For the positive surgical margin rate,early biochemical recurrence rate and median biochemical recurrence free survival time,no significant difference was found between the 2 groups (P ＞ 0.05).Conclusions Compared to classical RRP,the blood loss during the surgery,urine leakage rate and hospital stay could be significantly reduced in SLRP.Although the patients undergone SLRP could get quicker urinary continence recovery at 6 months after surgery,the urinary continence recovery at 12 months is identical between the 2 groups.RRP and SLRP could achieve nearly the same oncologic outcome.