title: A comparison of extraperitoneal and intraperitoneal approaches for robotic prostatectomy.
abstract: OBJECTIVE
  This study compared oncologic and health-related quality-of-life outcomes among patients undergoing intraperitoneal or extraperitoneal robotic prostatectomy.
  
  
  METHODS
  Of 215 patients undergoing robotic prostatectomy, the approach was intraperitoneal in 48 and extraperitoneal in 167. Cancer control was evaluated using margin status. Recovery after surgery and functional health was assessed using the convalescence and recovery evaluation and expanded prostate cancer index composite questionnaires, respectively.
  
  
  RESULTS
  Positive surgical margin rates were similar between approaches (14% extraperitoneal, 10% intraperitoneal; P = .63). Functional outcomes were slightly improved for those with the extraperitoneal approach (i.e., higher urinary irritation/obstruction scores at 3 months). The extraperitoneal group demonstrated higher activity (91.8 vs 83.3, P = .03) and cognitive scores (94.9 vs. 91.7, P = .04) at 6 weeks as well as higher gastrointestinal scores at 2 weeks (94.2 vs. 90.8, P = .05).
  
  
  CONCLUSIONS
  These data support efforts to broaden the adoption of the extraperitoneal approach for robotic prostatectomy.
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, MI 48109-2800, USA. brucejac@med.umich.edu
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Jacobs
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Montgomery
authors.forename: Rodney L
authors.initials: RL
authors.lastname: Dunn
authors.forename: Alon Z
authors.initials: AZ
authors.lastname: Weizer
authors.forename: David C
authors.initials: DC
authors.lastname: Miller
authors.forename: David P
authors.initials: DP
authors.lastname: Wood
authors.forename: J Stuart
authors.initials: JS
authors.lastname: Wolf
authors.forename: Yun
authors.initials: Y
authors.lastname: Zhang
authors.forename: John T
authors.initials: JT
authors.lastname: Wei
authors.forename: Brent K
authors.initials: BK
authors.lastname: Hollenbeck
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome