Laparoscopic radical prostatectomy after robotic radical prostatectomy training: A matched pair analysis of a single surgeon experience

ABSTRACT

OBJECTIVE@#The authors compared the perioperative, oncological, and functional outcomes of asingle surgeon’s prior experience with robot assisted laparoscopic prostatectomy (RALP) to those oflaparoscopic radical prostatectomy (LRP) which he performed later after RALP.@*METHODS@#This was a retrospective study on patients who underwent LRP and RALP by a single surgeonwho performed a similar antegrade approach to the prostate. Patients’ clinical characteristics werecollected— then a 11 pairing on LRP to RALP patients with the same preoperative profile. Pairedt-test with a level of significance was set at p<0.05 using MedCalc.@*RESULTS@#One hundred cases were done from April 2011 to March 2020. Out of eighty-four with sufficientdata, twelve pairs were matched with no significant difference on age (p=0.13), BMI (p=0.26), clinicalstage (p=1.0), prostate size (p=0.46), PSA (p=0.40) and Gleason score (p=1.0). Significant differencewas noted on lymph node dissection (p=0.003), number of isolated lymph nodes (p=0.038), durationof procedure (p=0.0263), and surgical margin (p=0.0069). No significant difference on lymph nodeyield (p=0.67), blood loss (p=0.95), hospital stay duration (p=0.71), perineural invasion (p=0.894),lymphovascular invasion (p=0.4783), extracapsular extension (p=0.843), seminal vesicle involvement(p=0.4783), follow-up PSA (p=1.000) for two years, complications (p=0.09), return of continence(p=0.287) and erectile dysfunction (p=1.0).@*CONCLUSION@#A trained robotic surgeon can perform laparoscopic radical prostatectomy with comparableperioperative, oncologic, and functional outcomes.