title: Open, laparoscopic and robot-assisted laparoscopic radical prostatectomy: comparative analysis of operative and pathologic outcomes for three techniques with a single surgeon's experience.
abstract: OBJECTIVE
  To compare outcomes of open (O-), laparoscopic (L-) and robot-assisted laparoscopic (RAL-) radical prostatectomy (RP) performed by the same surgeon.
  
  
  METHODS
  From May 1999 to April 2012, 484 RPs were performed by a single surgeon. Patients' data including age, body-mass index, serum prostate specific antigen (PSA) level, Gleason score of prostate biopsy and prostatectomy specimen, preoperative prostate and specimen volumes, clinical and pathologic stages, operation time, estimated blood loss (EBL), catheterization time, blood transfusion rate were recorded. Prospectively collected data was evaluated retrospectively by statistical analyses.
  
  
  RESULTS
  Of 484 radical prostatectomies, ORP (50), LRP (308) and RALRP (79) done by the same surgeon were included into study. Mean ages were 63.8, 62.7 and 60.3 years for ORP, LRP and RALRP respectively. Operation times for ORP, LRP and RALRP were 255, 208 and 242 minutes. EBL and hospitalization time were 602, 526, 234 mL, and 9.1, 3.2, 3.2 days for ORP, LRP and RALRP, respectively. While a significant advantage was found for EBL and complication rates in RALRP and for operation time in LRP, significant disadvantages were found in terms of catheterization time, hospitalization time, decrease in hemoglobin and blood transfusion in ORP. However, preoperative prostate volume and serum PSA level, oncologic outcomes and positive surgical margins were nearly similar in all operative techniques.
  
  
  CONCLUSIONS
  Minimally invasive techniques such as LRP and RALRP are promising techniques with comparable outcomes with ORP. Shorter catheterization time, less blood loss and fewer complication rates can be provided by RALRP.
authors.affiliation: Department of Urology, Selcuk University, School of Medicine, Konya, Turkey. dr@tibeterdogru.com.
authors.forename: M
authors.initials: M
authors.lastname: Akand
authors.forename: O
authors.initials: O
authors.lastname: Celik
authors.forename: E
authors.initials: E
authors.lastname: Avci
authors.forename: I
authors.initials: I
authors.lastname: Duman
authors.forename: T
authors.initials: T
authors.lastname: Erdogru
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D061646:Operative Time; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D066231:Surgeons; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen