Resultater etter DaVinci robotassistert radikal laparoskopisk prostatektomi. : Ett års oppfølging

Abstract

OBJECTIVES: To report on the initial experience of the first 150 patients with robot-assisted laparoscopic radical prostatectomy in Norway. METHODS: This was a nonrandomized retrospective study evaluating the initial 150 patients at the Norwegian Radiumhospital who underwent robot-assisted laparoscopic radical prostatectomy. Follow-up data were obtained retrospectively using patient journals and a self-designed data base at Radiumhospitalet, MedInsight. The follow-ups were scheduled at 6 weeks, 3 months, 6 months and 12 months. RESULTS: Average age of patients was 61,2 (45-74), average PSA 10,4 (0,2-78), average operation time 151 minutes. Average blood loss was 115 ml, no patients needed transfusions. The positive surgical margin rate was 29,3 % of all patients. The positive surgical margin for patients with pT ¡Ü2c was 14,7 %. 79 % of patients had minimal or no leakage after 6 weeks, 98,6 % of patients had minimal or no leakage after one year. 9,1 % of patients had good potency after one year, without using any form of specific treatment. One patient was converted to open surgery due to robot failure. One patient had a pulmonary embolus peroperatively. 4 patients got strictures in the anastomotic area postoperatively, successfully treated with blocking. CONCLUSIONS: Robot assisted radical prostatectomy has been introduced successfully. The procedure is quick, safe and with very few complications peroperatively and postoperatively, even during the initial learning fase. Results regarding histopathologic margins are in line with those published from other centers. Improvement of preoperative staging remains a challenge with respect to preoperative planning in order to achieve better histopathological results in pT3 prostate cancers while performing a lenient operation bearing side effects in mind.