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Robotgeassisteerde laparoscopische radicale prostatectomie in een perifeer ziekenhuis: perioperatieve parameters en korte termijn functionele en oncologische resultaten bij de eerste 400 patiënten

  • Robotgeassisteerde laparoscopische radicale prostatectomie in een perifeer ziekenhuis
  • Published:
Tijdschrift voor Urologie Aims and scope Submit manuscript

Samenvatting

Doelstelling:

Rapportage van de eerste 400 robotgeassisteerde radicale prostatectomieën (RALP), uitgevoerd in een perifeer ziekenhuis van januari 2009 tot en met januari 2011.

Methoden:

Pre- en postoperatieve oncologische parameters, operatieve karakteristieken en functionele en oncologische resultaten werden prospectief in een database verzameld. PSA-stijging (PSA ≥ 0,2) werd gebruikt als surrogaateindpunt voor progressie. Continentie en potentie werden geëvalueerd met behulp van gevalideerde vragenlijsten. Alle ingrepen werden uitgevoerd door 1 chirurg.

Resultaten:

De gemiddelde operatietijd bedroeg 125 minuten, het gemiddeld bloedverlies 329 ml en de gemiddelde opnameduur was 3,7 dagen. Complicaties traden op bij 5,8% van de patiënten. Een positief snijvlak werd gezien bij 77 van de 400 patiënten (19,2%). Het percentage positieve snijvlakken in de pT2- en de pT3-groep bedroeg respectievelijk 13,4% en 34,5%. Bij 73,5% van de patiënten werd een intermediair of hoogoncologisch risicoprofiel (Risicoclassificatie van D’Amico) vastgesteld. Na 12 maanden follow-up (n = 130) werd PSA-progressie vastgesteld bij 13,1% van de patiënten, was 90,2% van de patiënten continent en 60,7% van de preoperatief potente patiënten potent.

Conclusie:

RALP uitgevoerd in een hoogvolumekliniek gaat gepaard met zeer acceptabele morbiditeit en mortaliteit en met goede oncologische en functionele resultaten in een groep met een hoog percentage oncologisch intermediaire en hoogrisicopatiënten.

Summary

¦

Robot Assisted Laparoscopic Radical Prostatectomy in a peripheral hospital: peri-operative details and shortterm oncological and functional outcome in first 400 consecutive cases.

Objective:

We report the operative details and short-term oncological and functional outcome in 400 consecutive RALP cases performed in our hospital between January 2009 and January 2011.

Methods:

Pre-and post-operative oncological details, operative characteristics and functional and oncological outcome were prospectively collected in a database. PSA progression (PSA ≥ 0.2) was used as a surrogate endpoint of progression. Continence and potency were measured using validated questionaires. One surgeon performed all procedures.

Results:

Mean operative time was 125 minutes, mean blood loss 329 ml and mean hospital stay 3.7 days. Complications occurred in 5,8% of patients. A positive surgical margin was found in 77 of the 400 (19,2%) patients. The percentage positive surgical margins for the pT2 group and pT3 group were 13,4% and 34,5% respectively. Intermediate and high risk disease (D’Amico Risk Classification) was present in 73.5%. After 12 months of follow-up PSA progression was found in 13,1% of patients, 90% was continent and 60,7% of the previously potent patients recovered erectile function.

Conclusion:

RALP performed in a high volume hospital shows very acceptable morbidity and mortality with good oncological and functional outcome in a group with a high percentage of intermediate and high-risk disease.

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Authors and Affiliations

  1. afdeling Urologie, Maasstadziekenhuis, Rotterdam, The Netherlands

    S.S. Rambaran

  2. afdeling Urologie, Maasstadziekenhuis, Rotterdam, The Netherlands

    D. van den Ouden

  3. afdeling Pathologie, Maasstadziekenhuis, Rotterdam, The Netherlands

    M. Kliffen

  4. afdeling Urologie, Maasstadziekenhuis, Rotterdam, The Netherlands

    D.C.D. de Lange

  5. afdeling Urologie, Maasstadziekenhuis, Rotterdam, The Netherlands

    O.S. Klaver

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  1. S.S. Rambaran
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  2. D. van den Ouden
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  3. M. Kliffen
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  4. D.C.D. de Lange
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  5. O.S. Klaver
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anios urologie, uroloog, patholoog, uroloog, uroloog

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Rambaran, S., van den Ouden, D., Kliffen, M. et al. Robotgeassisteerde laparoscopische radicale prostatectomie in een perifeer ziekenhuis: perioperatieve parameters en korte termijn functionele en oncologische resultaten bij de eerste 400 patiënten. Tijdschrift voor Urologie 1, 126–132 (2011). https://doi.org/10.1007/s13629-011-0058-x

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