Robotic surgery in urology: facts and reality. What are the real advantages of robotic approaches for prostate cancer patients?

Robotic surgery in urology: facts and reality. What are the real advantages of robotic approaches... Purpose of reviewDespite the worldwile increasing use of robotic assistance for oncology surgery, no level 1 evidence-based benefit favoring robot-assisted radical prostatectomy (RARP) versus pure laparoscopic or open approaches has been demonstrated. We aimed to perform an update of the available evidence by evaluating most recent 2016–2017 data.Recent findingsPopulation-based and prospective nonrandomized studies and one phase III randomised trial have been recently published. Early results from the phase III trial suggested that RARP led to similar early functional and oncologic outcomes compared with open radical prostatectomy. Shorter operative time, hospital stay, and lower complications rate and blood loss were reported in RARP group compared with open radical prostatectomy group. Population-based data did not demonstrate any benefit from one approach over another in terms of functional and oncologic outcomes. Robot assistance is predictive for improved potency recovery in organ-confined tumor in one large prospective trial. Main limitations, different among studies, were lack of randomization or single operator cohorts, short-term follow-up, and absence of confounding factors analysis.SummaryRobotic assistance seems to confer better results than open radical prostatectomy procedures in terms of intra- and immediate postoperative parameters (operative time, blood loss and hospital stay). Clear advantages of one technique over another on robust functional or oncologic endpoints remain unproven. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Opinion in Urology Wolters Kluwer Health

Robotic surgery in urology: facts and reality. What are the real advantages of robotic approaches for prostate cancer patients?

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Publisher
Wolters Kluwer
Copyright
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
0963-0643
eISSN
1473-6586
D.O.I.
10.1097/MOU.0000000000000470
Publisher site
See Article on Publisher Site

Abstract

Purpose of reviewDespite the worldwile increasing use of robotic assistance for oncology surgery, no level 1 evidence-based benefit favoring robot-assisted radical prostatectomy (RARP) versus pure laparoscopic or open approaches has been demonstrated. We aimed to perform an update of the available evidence by evaluating most recent 2016–2017 data.Recent findingsPopulation-based and prospective nonrandomized studies and one phase III randomised trial have been recently published. Early results from the phase III trial suggested that RARP led to similar early functional and oncologic outcomes compared with open radical prostatectomy. Shorter operative time, hospital stay, and lower complications rate and blood loss were reported in RARP group compared with open radical prostatectomy group. Population-based data did not demonstrate any benefit from one approach over another in terms of functional and oncologic outcomes. Robot assistance is predictive for improved potency recovery in organ-confined tumor in one large prospective trial. Main limitations, different among studies, were lack of randomization or single operator cohorts, short-term follow-up, and absence of confounding factors analysis.SummaryRobotic assistance seems to confer better results than open radical prostatectomy procedures in terms of intra- and immediate postoperative parameters (operative time, blood loss and hospital stay). Clear advantages of one technique over another on robust functional or oncologic endpoints remain unproven.

Journal

Current Opinion in UrologyWolters Kluwer Health

Published: Mar 1, 2018

References

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