Robot-assisted versus three-dimensional laparoscopic radical prostatectomy: 12-month outcomes of a randomised controlled trial

Henry Haapiainen, Teemu J. Murtola, Juha Koskimäki, Jarno Riikonen, Tomi Pakarainen, Caelán M. Haney, Mika Raitanen, Antti Kaipia

Research output: Contribution to journalArticleScientificpeer-review

1 Citation (Scopus)
23 Downloads (Pure)

Abstract

Objectives: To compare functional and oncological outcomes of robot-assisted laparoscopic prostatectomy (RALP) to three-dimensional laparoscopic radical prostatectomy (3D-LRP) at 12 months after surgery. Patients and methods: Prospective randomised single-centre study of 145 consecutive men referred to radical prostatectomy in a tertiary referral centre in Finland. Patients were randomised 1:1 to the RALP (N = 75) and 3D-LRP (N = 70) groups. The primary outcome was urinary continence evaluated with the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) incontinence domain score at 12 months after surgery. Secondary outcomes included the use of protective pads at 12 months after surgery, EPIC-26 domain scores of irritative/obstructive, bowel, sexual and hormonal symptoms, positive surgical margin (PSM) rate, and biochemical recurrence (BCR). Complication frequency within the 3-month period after surgery was evaluated according to Clavien–Dindo classification. Statistical significance between groups was analysed using Mann–Whitney, chi-square and Fisher's exact tests. The trial was terminated after interim analysis based on no statistically significant difference in EPIC-26 urinary incontinence domain scores. Altogether 145 patients of the target accrual of 280 patients were recruited. Results: Postoperative continence at 12 months after surgery according to the EPIC-26 incontinence domain was 79.25 in both groups (P = 0.4). Between group difference was −5.8 (95% confidence interval –15.2 to 3.6). There was no statistically significant difference in the rates of PSM or BCR between the two surgical modality groups. Conclusion: We were unable to demonstrate a difference between the RALP and 3D-LRP groups for functional and oncological outcomes at 12 months after surgery.

Original languageEnglish
Pages (from-to)505-511
JournalBJU International
Volume132
Issue number5
Early online date2023
DOIs
Publication statusPublished - 2023
Publication typeA1 Journal article-refereed

Keywords

  • functional outcome
  • laparoscopic prostatectomy
  • prostate cancer
  • radical prostatectomy
  • robot-assisted laparoscopic prostatectomy

Publication forum classification

  • Publication forum level 2

ASJC Scopus subject areas

  • Urology

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