Prostatectomía radical laparoscópica asistida por robot, un año de experiencia en el Hospital Central Militar, reporte de los primeros 55 casos

Abstract

Aim

To present the first year experience of the robotic surgery project at the Hospital Central Militar that consisted of 55 consecutive cases of robotic-assisted laparoscopic radical prostatectomy.

Methods

With the incorporation of the robotic surgery system in November 2014 to November 2015, the same surgeon (JGCS) performed a total of 55 radical prostatectomies. In the present retrospective study, the following preoperative data were analyzed: ECOG, ASA risk, BMI, associated morbidities, previous radiotherapy, history of TURP, IPSS, erectile function, urinary continence index, PSA, prostatic volume, Gleason score, initial staging, and clinical stage. The intraoperative variables were: type of access, surgery duration, conversion rate, bleeding, blood transfusions, complications, type of anastomosis, and time with bladder catheter. The postoperative variables analyzed were: positive margins, biochemical recurrence, urinary continence, and erectile function.

Results

The mean age of the patients was 68 years and the mean PSA value was 7.80 ng/ml. In 50.9% of the cases, the Gleason score was 6 (3 + 3). Mean surgery duration was 270 min and mean estimated blood loss was 512 ml. Mean hospital stay and time with catheter was 5.9 and 8 days, respectively, and the positive margin rate was 18.1%. The rates for continence and potency at the follow-up at one, 3, 6, and 12 months were 41.8%, 78%, 88%, 100% and 29%, 41%, 68%, 66%, respectively.

Conclusions

The results of our initial experience with robotic radical prostatectomy are promising. We have been able to put robotic-assisted laparoscopic radical prostatectomy into practice at our hospital in a safe and reproducible manner with a minimum of adverse results.