title: Robot-assisted Versus Standard Laparoscopy for Simple Prostatectomy: Multicenter Comparative Outcomes.
abstract: To report a comparative analysis of laparoscopic simple prostatectomy (LSP) vs robot-assisted simple prostatectomy (RASP).
  
  
  
  Consecutive cases of LSP and RASP done between 2003 and 2014 at 3 participating institutions were included in this retrospective analysis. The effectiveness of the two procedures was determined by performing a paired analysis of main functional and surgical outcomes. A multivariate analysis was also conducted to determine the factors predictive of "trifecta" outcome (combination of International Prostate Symptom Score <8, Qmax > 15 mL/second, and no perioperative complications).
  
  
  
  A total of 319 patients underwent minimally invasive simple prostatectomy at the participating institutions over the study period. Total prostate volume was larger in the RASP group (median 118.5 mL vs 109 mL, P = .02). Median estimated blood loss tended to be higher for LSP (300 mL vs 350 mL, P = .07). There was no difference in terms of catheterization time (P = .3) and hospital stay (P = .42). A higher rate of overall postoperative complications was recorded in the RASP group (17.7% vs 5.3%), but rate of major complications was not significantly different between the two techniques (2.3 vs 2.1, P = .6). Subjective and objective parameters significantly improved for both LSP and RASP. On multivariable analysis, only two factors were associated with likelihood of obtaining a favorable (trifecta) outcome: age (odds ratio: 0.94; P = .03) and body mass index (odds ratio: 0.84; P = .03).
  
  
  
  Both LSP and RASP can be regarded as safe and effective minimally invasive surgical treatments for bladder outlet obstruction due to large prostate glands.
authors.affiliation: Urology Institute, University Hospitals, Cleveland, OH; Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Pavan
authors.affiliation: Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
authors.forename: Homayoun
authors.initials: H
authors.lastname: Zargar
authors.affiliation: Department of Urology, Institut Montsouris, Paris, France.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sanchez-Salas
authors.affiliation: Department of Urology, Clinica Indisa, Universidad Andres Bello, Santiago, Chile.
authors.forename: Octavio
authors.initials: O
authors.lastname: Castillo
authors.affiliation: Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Celia
authors.affiliation: Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gallo
authors.affiliation: Department of Urology, Institut Montsouris, Paris, France.
authors.forename: Arjun
authors.initials: A
authors.lastname: Sivaraman
authors.affiliation: Department of Urology, Institut Montsouris, Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
authors.affiliation: Urology Institute, University Hospitals, Cleveland, OH; Urology Unit, Second University of Naples, Napoli, Italy. Electronic address: ricautor@gmail.com.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Autorino
mesh_terms: D000368:Aged; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000601:surgery*