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Offene, laparoskopische und roboterassistierte radikale Prostatektomie im Vergleich

Comparison between open, laparoscopic and robot-assisted radical prostatectomy

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Aufgrund der heutigen Datenlage weist weder die offene noch die laparoskopische oder die roboterassistierte radikale Prostatektomie einen Vorteil gegenüber den anderen Operationstechniken auf. Der Nachbeobachtungszeitraum für die minimal-invasiven Techniken ist jedoch zu kurz, um endgültige Schlüsse bezüglich der onkologischen Ergebnisse ziehen zu können. Die funktionellen Ergebnisse wie postoperative Kontinenz und Potenz scheinen untereinander vergleichbar zu sein. Der Vergleich zwischen den Studien wird jedoch durch die fehlenden einheitlichen Definitionen der Endpunkte erschwert. Die heutige Datenlage lässt vermuten, dass vielmehr die Erfahrung und die Expertise des Operateurs und der Zentren für vorteilhafte Ergebnisse verantwortlich ist, da die meisten spezialisierten Zentren gute bis sehr gute Ergebnisse berichten. Dies unterstützt die Forderung nach der Bildung von Prostatakarzinomzentren, um Nebenwirkungen und Kosten der Behandlung gering und die Lebensqualität der Patienten nach der Operation hoch zu halten.

Abstract

Based on the available literature, neither open nor laparoscopic nor robot-assisted radical prostatectomy demonstrates advantages in post-operative results relative to the other technique. However, the follow-up of the laparoscopic and the robot-assisted technique is still too short to allow conclusions to be drawn on cancer control. The functional results regarding post-operative continence and potency demonstrate comparable rates for each of the techniques. However, the comparison between the studies is complicated by the lack of standardized endpoints and methodology. The data suggest that the expertise and experience of the surgeons and the centres are the most important variables influencing post-operative results of radical prostatectomy, as most of the specialized centres report good results. This emphasizes the need for prostate cancer centres, in order to reduce costs and side effects related to the treatment and in order to improve post-operative quality of life of patients.

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  1. Klinik für Urologie, Universitätsklinik Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    J. Walz & H. Huland

  2. Prostatazentrum, Hamburg, Deutschland

    M. Graefen & H. Huland

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Walz, J., Graefen, M. & Huland, H. Offene, laparoskopische und roboterassistierte radikale Prostatektomie im Vergleich. Onkologe 13, 701–709 (2007). https://doi.org/10.1007/s00761-007-1226-8

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