Perioperative Quality Of Care Indicators Of Retropubic Laparoscopic And Robotic Prostatectomy: Results From A National, Multicenter, Prospective Cohor

UroToday.com - This report attempted to address the important clinical question of which approach for the man with prostate cancer is best. Over a 30 month period (03/03-10/05), 517 men were enrolled into this study evaluating efficacy and tolerability of open retropubic compared with laparoscopic and robotic approaches. In spite of this prospective approach, clear biases in selection resulted in groups that were not truly comparable at the study conclusion. The protocol involved only high volume centers of excellence with uro-oncologists performing the surgery.

In all approaches results were comparable apart from transfusion rates, where open prostatectomy was the highest at 6%. The advantage of reduced blood loss however has limited clinical benefit when compared to other more meaningful endpoints such as positive margins, continence or re-admission rates, all of which demonstrated no difference between approaches.

Conclusions: The authors conclude there is no significant advantage of one surgical approach over the others in this large prospective series involving more than 500 men as a result of selection bias and surgeon's preference.

AUA 2006 - Abstract 1151 - Hu et al

Reviewed by UroToday.com Contributing Editor Gerry Brock, MD

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