Five year experience in prostate cancer surgery on «Da Vinci» robot

Abstract

THE AIM: to analyze the results and estimation of efficacy of robot-assisted radical prostatectomy (RARP) in patients with prostate cancer (PCa). PATIENTS AND METHODS. Between 2010 and 2016 we performed 257 RARP in patients with PCa stage T1-T3aN0M0, Gleason 4-9, 48-78 years old with 11,5-155 ml prostate volume and 3,1-120 ng/ml general PSA level. We performed standard and modified RARP technique which included the preserving and reconstruction of periprostatic anatomical structures of pelvic. RESULTS. The operative time was 170±50 min, blood loss - 130±35 ml. There were no conversions, the intraoperative complications rate was 2,1%. Postoperative Clavien I-II rate - 21%, Clavien III - 3,5%, Clavien IV-V - 0%. Hospital stay was 12,0±4,2 days, urethral catheter removed on day 7-8. The continence rate was 91% and 98,6% after 1 and 12 months respectively, the potency recovery rate was 72% and 92% in 1 and 12 months respectively. The positive surgical margin rate was 14%. The “trifecta” and “pentafecta” were achieved in 87% and 52% respectively after 12 months. Five-years cancer-free survival rate, cancer-specific and overall survival rate were 94%, 100% and 97,5% respectively. CONCLUSION. Due to construction benefits of da Vinci robotic system we may now achieve preserving, reconstruction and enhancing of periprostatiс anatomical structures which are participated in continence mechanism. The improving of RARP technique should contribute to early continence recovery in patients with PCa.