TY - JOUR
T1 - Extraperitoneal v intraperitoneal robotic prostatectomy
T2 - Analysis of operative outcomes
AU - Madi, Rabii
AU - Daignault, Stephanie
AU - Wood, David P.
PY - 2007/12/1
Y1 - 2007/12/1
N2 - Background and Purpose: Robotic prostatectomy can be performed either via an extra- or intraperitoneal approach. The extraperitoneal approach has advantages similar to those of an extraperitoneal open radical prostatectomy, but the potential disadvantages of a small working space. We report our experience using both approaches. Methods: From July 2003 to June 2004, 55 patients underwent a robot-assisted laparoscopic prostatectomy. During the first 6 months, 21 prostatectomies were performed using an intraperitoneal approach (group 1); 34 were performed using an extraperitoneal approach (group 2) during the next 6 months. Clinicopathologic parameters and perioperative complications were compared in both groups. All patients were categorized as intent-to-treat analysis. Results: Median surgery time was significantly shorter in the extraperitoneal compared with the intraperitoneal approach (3 hours and 34 minutes v 4 hours and 1 minute, respectively, P = 0.017). This was because of the shorter time interval between the skin incision and incision of the endopelvic fascia in the extraperitoneal v the intraperitoneal approach (55 minutes v 74 minutes, respectively, P < 0.0001). There was no significant difference in terms of patient age, clinical and pathologic stage, length of hospital stay, and perioperative complications between the two approaches. Conclusion: Extraperitoneal robot-assisted laparoscopic prostatectomy offers a similar clinical outcome as the intraperitoneal approach. However, the extraperitoneal approach avoids potential bowel injury or complications related to an intraperitoneal urine leak.
AB - Background and Purpose: Robotic prostatectomy can be performed either via an extra- or intraperitoneal approach. The extraperitoneal approach has advantages similar to those of an extraperitoneal open radical prostatectomy, but the potential disadvantages of a small working space. We report our experience using both approaches. Methods: From July 2003 to June 2004, 55 patients underwent a robot-assisted laparoscopic prostatectomy. During the first 6 months, 21 prostatectomies were performed using an intraperitoneal approach (group 1); 34 were performed using an extraperitoneal approach (group 2) during the next 6 months. Clinicopathologic parameters and perioperative complications were compared in both groups. All patients were categorized as intent-to-treat analysis. Results: Median surgery time was significantly shorter in the extraperitoneal compared with the intraperitoneal approach (3 hours and 34 minutes v 4 hours and 1 minute, respectively, P = 0.017). This was because of the shorter time interval between the skin incision and incision of the endopelvic fascia in the extraperitoneal v the intraperitoneal approach (55 minutes v 74 minutes, respectively, P < 0.0001). There was no significant difference in terms of patient age, clinical and pathologic stage, length of hospital stay, and perioperative complications between the two approaches. Conclusion: Extraperitoneal robot-assisted laparoscopic prostatectomy offers a similar clinical outcome as the intraperitoneal approach. However, the extraperitoneal approach avoids potential bowel injury or complications related to an intraperitoneal urine leak.
UR - http://www.scopus.com/inward/record.url?scp=38049155964&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=38049155964&partnerID=8YFLogxK
U2 - 10.1089/end.2007.9872
DO - 10.1089/end.2007.9872
M3 - Article
C2 - 18186697
AN - SCOPUS:38049155964
SN - 0892-7790
VL - 21
SP - 1553
EP - 1557
JO - Journal of Endourology
JF - Journal of Endourology
IS - 12
ER -