Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/946
Title: Operative details and oncological and functional outcome of robotic-assisted laparoscopic radical prostatectomy: 400 cases with a minimum of 12 months follow-up.
Epworth Authors: Murphy, Declan
Crowe, Helen
Costello, Anthony
Kerger, Michael
Peters, Justin
Keywords: Robotic-Assisted Laparoscopic Radical Prostatectomy
RALP
Robotics
da Vinci Surgical System
Laparoscopy
Registries
PSA
Prostatectomy
Neoplasms, Prostate
Prostatic Neoplasms
Cancer of the Prostate
Treatment Outcome
Six Port Transperitoneal Approach
Risk Assessment
Survival Analysis
Neoplasm Staging
Prostate-Specific Antigen
Sexual Dysfunction, Physiological
SHIM Score
Sexual Health Inventory for Men
​UroRenal & Vascular Clinical Institute, Epworth HealthCare, Richmond, Victoria, Australia.
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Australian Prostate Cancer Research Centre, Epworth HealthCare, Richmond, Victoria, Australia.
Issue Date: Jun-2009
Publisher: Elsevier
Citation: Eur Urol. 2009 Jun;55(6):1358-66.
Abstract: BACKGROUND: Robotic-assisted laparoscopic radical prostatectomy (RALP) using the da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA) is increasingly used for the management of localised prostate cancer. OBJECTIVE: We report the operative details and short-term oncological and functional outcome of the first 400 RALPs performed at our unit. DESIGN, SETTING AND PARTICIPANTS: From December 2003 to August 2006, 400 consecutive patients underwent RALP at our institution. A prospective database was established to record the relevant details of all RALP cases. SURGICAL PROCEDURE: A six port transperitoneal approach using a 4-arm da Vinci system was used to perform RALP. This database was reviewed to establish the operative details and oncological and functional outcome of all patients with a minimum of 12 months follow-up. MEASUREMENTS: Perioperative characteristics and outcomes are reported. Functional outcome was assessed using continence and erectile function questionnaires. Biochemical recurrence (prostate-specific antigen (PSA) > or =0.2 ng/mL) is used as a surrogate for cancer control. RESULTS AND LIMITATIONS: The mean age+/-standard deviation (SD) was 60.2+/-6 years. Median PSA level was 7.0 (interquartile range (IQR) 5.3-9.6) ng/mL. The mean operating time+/-SD was 186+/-49 mins. The complication rate was 15.75% comprising Clavien grade I-II and Clavien grade III complications in 10.5% and 5.25% of patients respectively. The overall positive surgical margin rate was 19.2% with T2 and T3 positive margin rates of 9.6% and 42.3% respectively. The biochemical recurrence-free survival was 86.6% at a median follow-up of 22 (IQR=15-30) months. At 12 months follow-up, 91.4% of patients were pad-free or used a security liner. Of those men previously potent (defined as Sexual Health Inventory for Men [SHIM] score > or =21) who underwent nerve-sparing RALP, 62% were potent at 12 months. CONCLUSIONS: The safety and feasibility of RALP has already been established. Our initial experience with this procedure shows promising short-term outcomes.
URI: http://hdl.handle.net/11434/946
DOI: 10.1016/j.eururo.2008.12.035
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/19147274
ISSN: 0302-2838
Journal Title: European Urology
Type: Journal Article
Affiliated Organisations: Department of Urology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Type of Clinical Study or Trial: Prospective Cohort Study
Appears in Collections:Cancer Services
UroRenal, Vascular
Epworth Prostate Centre

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