title: Quality of evidence to compare outcomes of open and robot-assisted laparoscopic prostatectomy.
abstract: Robot-assisted laparoscopic radical prostatectomy (RALP) has gained widespread acceptance in the treatment of prostate cancer. While it increasingly is becoming the surgical approach of choice in many centers, limited data exist directly comparing it to radical retropubic prostatectomy (RRP). This review examines the evidence comparing RALP to RRP. The outcomes evaluated are arranged into perioperative, oncologic, and functional outcomes. Of the 21 publications meeting our selection criteria, Level II, III, and IV evidence were found in 9, 1, and 11 articles, respectively. Overall, RALP was associated with lower blood loss, transfusion rates, length of stay, and higher cost when compared to RRP. Definitive conclusions regarding complications and oncologic and functional outcomes are not yet possible, and will require longer-term follow-up and well-designed randomized controlled trials.
authors.affiliation: Department of Urology, University of Minnesota, MMC 394, 420 Delaware Street Southeast, Minneapolis, MN 55403, USA.
authors.forename: Branden
authors.initials: B
authors.lastname: Duffey
authors.forename: Briony
authors.initials: B
authors.lastname: Varda
authors.forename: Badrinath
authors.initials: B
authors.lastname: Konety
mesh_terms: D019317:Evidence-Based Medicine; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018570:Risk Assessment; D012371:Robotics / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods
chemical_list: D017430:Prostate-Specific Antigen