ISSN: 2578-4676
Authors: Tobias-Machado M*, x Silva Cunha FT, Pazeto CL and Luz M
Introduction and Objective: Laparoscopic and robot-assisted simple prostatectomies are considered feasible options for treatment of benign prostate hyperplasia (BPH). We sought to compare perioperative and functional outcomes during learning curve of surgeons for open, laparoscopic and robotic techniques. Material and Methods: Data was prospectively collected from 100 patients subjected to simple prostatectomy. Demographic and perioperative data were evaluated. Postoperative success, measured by improvement in IPSS and Qmax, and patient satisfaction were compared. ANOVA test was used to assess quantitative data and compare means. Chi-square test was used to compare categorical variables. Results: Sixty patients underwent Open Simple Prostatectomy (OSP), 20 Laparoscopic Simple Prostatectomy (LSP) and 20 Robot assisted technique (RASP). Mean catheter time (OSP: 8,5 x LSP: 5 x RASP: 4 days, p=0,04) and hospital stay (OSP: 4,5 x LSP: 2,2 x RASP: 2 days, p=0,04) were higher on patients submitted to open approach. There was no statistically difference in irrigation time (OSP: 2,7 x LSP: 1,5 x RASP: 1,5 days, p=0,06). Intraoperative bleeding (OSP: 1000 x LSP: 530 x RASP: 350 ml, p=0,02) and need for transfusion (OSP: 5/60 x LSP: 1/20 x RASP: 0/20 cases, p=0,003) were higher in OSP group. No evidence of statistically difference of IPSS or Qmax improvements and patient satisfaction between-groups were found. Conclusion: Simple prostatectomy can be safely and effectively performed in a minimally invasive fashion for surgeons at learning curve. Significant gains were observed in reduction of severe complication, blood loss, need for transfusion and hospital stay compared to open surgery.
Keywords: Prostatic Hyperplasia; Prostatectomy; Morbidity; Learning Curve
