title: Perioperative complications after radical prostatectomy: open versus robot-assisted laparoscopic approach.
abstract: BACKGROUND
  The best technique of radical prostatectomy - open versus robot-assisted approach - is controversially discussed. In this study, we compared the complication rates of open and robot-assisted radical prostatectomy during the introduction and subsequent routine use of a da Vinci® robotic device while open surgery remained the standard approach.
  
  
  METHODS
  Between January 1st, 2006, and June 4th, 2012, 2,754 men underwent radical prostatectomy at our department. Among them, 317 received robot-assisted and 2,438 open surgery. According to the requirements for prostate cancer centers certified by the Deutsche Krebsgesellschaft (German Cancer Society), a prospective database recording perioperative complications was built up. The complication rates of open and robot-assisted radical prostatectomy were compared with the χ(2) or Fisher exact test. The distributions of quantitative variables were compared with U tests.
  
  
  RESULTS
  Whereas the demographic factors favored patients selected for robot-assisted radical prostatectomy, there were no differences between open and robot-assisted surgery concerning length of stay, autologous blood transfusion rates and the incidence of perioperative complications.
  
  
  CONCLUSIONS
  Open and robot-assisted radical prostatectomy had comparable complication rates. With better patient- and tumor-related parameters as well as decreasing transfusion rates in the robot-assisted subgroup, this observation might reflect the learning curves of the involved robotic surgeons.
authors.affiliation: Department of Urology, University Hospital 'Carl Gustav Carus', Dresden University of Technology, Dresden, Germany. Michael.Froehner@uniklinikum-dresden.de
authors.forename: Michael
authors.initials: M
authors.lastname: Froehner
authors.forename: Vladimir
authors.initials: V
authors.lastname: Novotny
authors.forename: Rainer
authors.initials: R
authors.lastname: Koch
authors.forename: Steffen
authors.initials: S
authors.lastname: Leike
authors.forename: Lars
authors.initials: L
authors.lastname: Twelker
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Wirth
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D016009:Chi-Square Distribution; D002983:Clinical Competence; D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D059032:Learning Curve; D007902:Length of Stay; D008210:Lymphocele / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy; D011468:Prostatectomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods / Q000401:mortality; D012371:Robotics / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D013523:Surgical Equipment; D013997:Time Factors; D016896:Treatment Outcome