Newer Prostate Cancer Treatment Similar to Traditional Surgery
From Washington Post.com
"This reaffirms what many other manuscripts have shown, if you go to an individual who has experience, who does this on a consistent basis, your outcomes will be better," said Dr. Ihor S. Sawczuk, chief of urologic oncology for the Cancer Center at Hackensack University Medical Center, in New Jersey. "If you go to someone who does 20 to 50 procedures a year, that's better than somebody who only does two to three a year."
The only study I am aware of does not sure a large difference between the open and minimally invasive prostate cancer surgeries.
I agree with Dr. Sawczuk, a friend and colleague, that more experienced surgeons are more likely to have better results. The surgeon is important, probably more so than the technique. I think the best way to analyze this would have been to set up a study looking at high volume robotic vs. lap vs. open surgeons andhaving a 3rd party analyze the results. I do not think this is something that would ever be done.
My feeling after performing many open prostate cancer surgeries, a few laparoscopic ones, and over 400 robotic ones is that robotics gives me the ability to perform more accurate surgery, and the difference is more pronounced with more difficult cases.
Being able to remove the catheter within 3 days routinely without needing X-Rays would be difficult for me to achieve with open or laparoscopic surgery.
Posted by Domenico Savatta, M.D. | Permalink
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The current study prospectively compared length of hospital stay in 374 patients who underwent conventional RP and 629 who underwent LRP between 2002 and 2005. These authors reported that 94.3% of patients undergoing RP and 97.5% undergoing LRP were discharged on or before postoperative day 1. The mean stay for patients receiving RP was 1.25 days compared to 1.17 days for those receiving LRP. Readmission rates were 7% for the RP group and 5% for the LRP group. None of these differences were statistically significant. Unscheduled visits to the emergency room occurred in 10% of both groups. The major cause of hospital visits was ileus. These authors concluded that both groups of patients could be treated on the same clinical pathway as they had similar problems.