Open radical prostatectomy and laparoscopic radical prostatectomy: perioperative comparison of the procedures

Abstract

Radical prostatectomy is seen as one of the main methods for the treatment of prostate cancer and has been performed for more than 150 years, being considered the gold standard for the treatment of localized disease. In recent years, laparoscopic and robot-assisted access has received notoriety, with oncological results similar to the open technique associated with the benefits of the minimally invasive approach. Aim: To compare complications and perioperative complications in patients undergoing radical open prostatectomy with the laparoscopic approach. Method: This is a retrospective data analysis performed by reviewing the electronic medical records of patients diagnosed with localized prostate cancer at the Regional Hospital of Vale do Paraíba, SP, Brazil (HRVP). Data were collected regarding the procedures performed from January 2014 to December 2018, totaling 35 patients undergoing Laparoscopic Radical Prostatectomy and 35 patients undergoing Open Radical Prostatectomy. Intra and perioperative data were analyzed, specifically the surgical time, blood transfusion rate, type and time of drainage of the surgical site, and length of hospital stay. The data were subsequently analyzed, and the results of both techniques were compared. Results: When comparing the averages of operative times, we obtained a variation rate of 26.2%. The calculated p-value was 0.00002, demonstrating that the operative time in the open group was significantly shorter. When comparing the mean time taken to remove the drain, we observed a variation rate of 37.8%. The calculated p-value was 0.00004, this time being statistically shorter in the laparoscopy group. The other variables evaluated did not show statistical significance between the groups. Conclusion: The main advantage of an open group is that the procedure can be performed in less time. The main advantage of the laparoscopic group was the possibility of removing the drain before patients were operated on by PRA.