Does robotic prostatectomy meet its promise in the management of prostate cancer?
Journal
Current Urology Reports
Journal Volume
14
Journal Issue
3
Pages
184-191
Date Issued
2013
Author(s)
Abstract
Following Walsh's advances in pelvic anatomy and surgical technique to minimize intraoperative peri-prostatic trauma more than 30 years ago, open retropubic radical prostatectomy (RRP) evolved to become the gold standard treatment of localized prostate cancer, with excellent long-term survival outcomes [1?]. However, RRP is performed with great heterogeneity, even among high volume surgeons, and subtle differences in surgical technique result in clinically significant differences in recovery of urinary and sexual function. Since the initial description of robotic-assisted radical prostatectomy (RARP) in 2000 [2], and U.S. Food and Drug Administration approval shortly thereafter, RARP has been rapidly adopted and has overtaken RRP as the most popular surgical approach in the management of prostate cancer in the United States [3]. However, the surgical management of prostate cancer remains controversial. This is confounded by the idolatry of new technologies and aggressive marketing versus conservatism in embracing tradition. Herein, we review the literature to compare RRP to RARP in terms of perioperative, oncologic, and quality-of-life outcomes as well as healthcare costs. This is a particularly relevant, given the absence of randomized trials and long-term (more than 10-year) follow-up for RARP biochemical recurrence-free survival. ? 2013 Springer Science+Business Media New York.
Subjects
Continence; Oncological; Open retropubic radical prostatectomy; Outcomes; Potency; Prostate cancer; Robotic-assisted radical prostatectomy
SDGs
Other Subjects
article; blood transfusion; cancer recurrence; comparative study; erectile dysfunction; evidence based practice; health care cost; human; intermethod comparison; length of stay; oncological parameters; open retropubic radical prostatectomy; operation duration; outcome assessment; perioperative period; positive surgical margin; postoperative complication; postoperative hemorrhage; postoperative pain; prostate cancer; prostatectomy; quality of life; recurrence free survival; robotic assisted radical prostatectomy; robotics; salvage therapy; surgical mortality; surgical technique; urine incontinence; Disease-Free Survival; Erectile Dysfunction; Health Care Costs; Humans; Male; Prostatectomy; Prostatic Neoplasms; Quality of Life; Robotics; Treatment Outcome; Urinary Incontinence
Type
journal article