SAN FRANCISCO — Robotic radical prostatectomy had a complication rate of about 5.1% and promising medium-term outcomes, according to a large case series presented in two posters at the annual meeting of the Society of Laparoendoscopic Surgeons.
This complication rate is similar to those reported in large series of open radical prostatectomies and lower than those reported in laparoscopic and other robotic series, wrote Dr. Pankaj P. Dangle and colleagues from The Ohio State University Medical Center, Columbus.
According to the first poster, among 1,256 procedures performed by a single surgeon (Dr. Vipul R. Patel), there were 64 complications: 2 intraoperative, 16 perioperative, and 46 postoperative. No patients died, and no patients had to be converted to open repair.
Four patients had myocardial infarctions, four required blood transfusions, and three had pulmonary emboli.
Anastomotic leakage was the most common complication, occurring in 1.75% of the cases.
Other indicators also pointed to a learning curve with robotic radical prostatectomy. For example, the overall complication rate was 9.33% among the first 300 patients, but 3.37% among the last 300 patients.
In the second poster, the investigators extended the case series to 1,500 patients, with all procedures performed by Dr. Patel over a 56-month period. As in the original series, he used the da Vinci Surgical System, and he performed the procedure transperitoneally using a six-trocar technique.
The patients' average age was 61, and their mean body mass index was 29 kg/m
Overall, 97% of the patients were discharged home on the first postoperative day, and the mean catheter time was 6.3 days. After 3 months, 92% of the patients were completely continent; that number went up to 97% after 6 months and 98% after 12 months.
The investigators, who disclosed that they have no financial relationships related to their presentation, concluded that robotic-assistant laparoscopic radical prostatectomy is a safe, feasible, and minimally invasive alternative for treating clinically localized prostate cancer.