CLO19-054: Initial Experience of a Newly Set-up Robotic Assisted Radical Prostatectomy Program From a Developing Country—Delineating the Learning Curve

Authors: Shantanu Tyagi MBBS, MS1, Arandam Roy MBBS1, Ravimohan Mavuduru MBBS, MS, MCh1, Girdhar Bora MBBS, MS, MCh1, Tushar Aditya Narain MBBS, MS, MCh1, and Arup Kumar Mandal MBBS, MS, MCh1
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  • 1 Post Graduate Institute of Medical Education and Research, Chandigarh, India

Background: Historically, the incidence of prostate cancer in India and in nonresident Indians is lower than that in Western populations. Our study aims to assess complications and short-term outcomes of robotic assisted radical prostatectomy (RARP) among postoperative patients from a tertiary care center of a developing country. Materials & Method: Prospective cohort/next 50 group, surgery between July 2017 to September 2018: Preoperative variables included demographic profile, MRI findings, PSA values, prostate biopsy reports including the Gleason score, erectile function assessment using the IIEF-5 questionnaire. Intraoperative variables included duration of surgery, blood loss, status of neurovascular bundles, whether could be preserved, lymph node dissection, and its extent. Postoperative variables included complications following the surgery (Clavien-Dindo classification), hospital stay, time of indwelling catheter. Follow-up data included serum PSA levels, status of urinary continence (daily urinary pad log ), and sexual function (IIEF 5 scores) at 3 months from surgery, then every 3 months. Retrospective cohort/first 50, surgery between December 2014 to 30th June 2017: Preoperative, intraoperative, and postoperative variables were recorded like in prospective cohort and were followed prospectively during study period. Results: Preoperative variables were comparable between two groups (–).Operative duration was significantly better in “next 50” group (mean, 236 minutes; range, 100–450 minutes) as compared to “first 50” group (mean, 350 minutes; range, 178–560 minutes, Duration of hospital stay is significantly less in “next 50” group (mean, 2.6 vs 4.5 days). Postoperative complications were also less commonly noted in “next 50” group (5% vs 14%; ). Comparative postoperative erectile dysfunction rates were significantly less in “next 50” group (6% vs 36%), and though the postoperative incontinence rates were less in “next 50” group, it was found to be statistically insignificant (). Conclusion: Robotic-assisted radical prostatectomy is a safe and feasible option for the treatment of clinically localized prostate cancer. After due course of training period favorable and promising results can be replicated at a newly set robotic program.

Background: Historically, the incidence of prostate cancer in India and in nonresident Indians is lower than that in Western populations. Our study aims to assess complications and short-term outcomes of robotic assisted radical prostatectomy (RARP) among postoperative patients from a tertiary care center of a developing country. Materials & Method: Prospective cohort/next 50 group, surgery between July 2017 to September 2018: Preoperative variables included demographic profile, MRI findings, PSA values, prostate biopsy reports including the Gleason score, erectile function assessment using the IIEF-5 questionnaire. Intraoperative variables included duration of surgery, blood loss, status of neurovascular bundles, whether could be preserved, lymph node dissection, and its extent. Postoperative variables included complications following the surgery (Clavien-Dindo classification), hospital stay, time of indwelling catheter. Follow-up data included serum PSA levels, status of urinary continence (daily urinary pad log ), and sexual function (IIEF 5 scores) at 3 months from surgery, then every 3 months. Retrospective cohort/first 50, surgery between December 2014 to 30th June 2017: Preoperative, intraoperative, and postoperative variables were recorded like in prospective cohort and were followed prospectively during study period. Results: Preoperative variables were comparable between two groups (Tables 13).Operative duration was significantly better in “next 50” group (mean, 236 minutes; range, 100–450 minutes) as compared to “first 50” group (mean, 350 minutes; range, 178–560 minutes, Duration of hospital stay is significantly less in “next 50” group (mean, 2.6 vs 4.5 days). Postoperative complications were also less commonly noted in “next 50” group (5% vs 14%; Table 4). Comparative postoperative erectile dysfunction rates were significantly less in “next 50” group (6% vs 36%), and though the postoperative incontinence rates were less in “next 50” group, it was found to be statistically insignificant (Table 5). Conclusion: Robotic-assisted radical prostatectomy is a safe and feasible option for the treatment of clinically localized prostate cancer. After due course of training period favorable and promising results can be replicated at a newly set robotic program.

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Corresponding Author: Shantanu Tyagi, MS, Mch
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