The researchers found, based on a representative 20 per cent sample of the United States that:
• 19,278 patients underwent RARP or ORP in 647 medical institutions between October 2008 and December 2009.
• Of those, 11,889 underwent RARP and 7,389 underwent ORP.
• More RARPs were performed at teaching institutions in urban locations, and a higher proportion of RARPs were performed at high-volume hospitals.
• RARP patients were less likely than ORP patients to need a blood transfusion, less likely to have a prolonged hospital stay, and less like to suffer complications during or after surgery, including cardiac, respiratory, and vascular problems.
ORP involves opening the lower abdomen with a long incision, and removing the entire diseased prostate gland and some surrounding tissue in the hope of preventing the cancer from spreading to other parts of the body.
A similar procedure, known as RARP, is done through tiny incisions using minimally invasive laparoscopic surgery. Henry Ford Hospital pioneered the use of robots to assist surgeons in this delicate procedure, and the new study confirms earlier Henry Ford findings that RARP is now the most common technique in the U.S. for treating localised prostate cancer.
Prostate cancer is the most common "solid organ" malignancy and the second leading cause of cancer death in U.S. men. Radical prostatectomy became the standard treatment after it was shown that the surgery resulted in higher survival rates than "watchful waiting."
But in the past 10 years, "we have seen a significant trend toward the use of minimally invasive approaches to RP for the treatment of prostate cancer, particularly in the U.S.," says Doctor Quoc-Dien Trinh, lead author of the study.
"While this evolution has been controversial, there have been few comparative studies. Most of those looked only at single institutions or single surgeons, and they were of poor evidentiary quality."
Most significantly, the new study found "superior" results with RARP in virtually every outcome studied, including the amount of necessary blood transfusions, complications during and after surgery, and length of hospital stay.
MEDICA.de; Source: Henry Ford Hospital