Is there any evidence of superiority between retropubic, laparoscopic or robot-assisted radical prostatectomy?

• Published in: International Brazilian journal of urology Vol. 37; no. 2; pp. 146 - 160
• Main Authors: Ferronha, Frederico, Barros, Fortunato, Santos, Victor Vaz, Ravery, Vincent, Delmas, Vincent
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Urologia 01-04-2011
• Subjects: Erectile Dysfunction - etiology; Evidence-Based Medicine; Follow-Up Studies; Humans; laparoscopic prostatectomy; Laparoscopy; Male; open prostatectomy; outcomes; Prostatectomy - adverse effects; Prostatectomy - methods; retropubic prostatectomy; robotic prostatectomy; Robotics; Treatment Outcome; Urinary Incontinence - etiology
• ISSN: 1677-5538; 1677-6119; 1677-5538
• DOI: 10.1590/S1677-55382011000200002

To compare the perioperative, short-term and long-term postoperative results of radical retropubic prostatectomy (RRP), laparoscopic radical prostatectomy (LRP) and robotic assisted laparoscopic prostatectomy (RALP) in the most recent studies evaluable.
Using PubMed we have undertaken a search based on references from major and recent articles with considerable sample sizes.
The operative blood loss and the risk of transfusion were lower in the laparoscopic and robotic-assisted approaches. The surgical duration was shorter in the open and robotic group. Regarding the positive margins, continence and potency no substantial differences between the RRP, LRP, and RALP were found.
Our results suggest that no one surgical approach is superior in terms of functional and early oncologic outcomes. Potential advantages of any surgical approach have to be confirmed through longer-term follow-up and adequately designed clinical studies.