Localized Prostate Cancer Treatment – Robot Assisted Surgery Better Than Open Surgery

April 25, 2012 by  
Filed under Prostate Cancer Surgery

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 Radical prostatectomy is the surgical procedure applied to get rid of prostate gland affected by cancer. This is often carried out when the cancer is still localized ( that is, still within the confines of  the prostate cells). The surgical procedure is of two types: one is the open radical prostatectomy (ORP) and the Robot-Assisted Radical Prostatectomy (RARP).The former is much more invasive than the latter.

A recent study published in the European Urology journal has revealed that the applications of Robot-Assisted Prostate cancer surgery are much more successful than the open radical prostatectomy. The reason is that it provides men with better outcomes and fewer complications. The following extract throws more light into this publication:

Robot-assisted surgery is now both more common and far more successful than radical “open” surgery to treat prostate cancer in the United States, according to a new Henry Ford Hospital study published in the current issue of the medical journal European Urology. The research, led by scientists at Henry Ford Hospital’s Vattikuti Urology Institute (VUI), is the first to compare in a nationwide population sample the results of robot-assisted radical prostatectomy (RARP) to the standard surgical procedure, open radical prostatectomy (ORP).

The researchers found, based n a representative 20 percent sample of the U.S. 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 United States for treating localized 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’ve 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 Quoc-Dien Trinh, M.D., a fellow at VUI and 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.

At Henry Ford, which did much of the original work on robotic surgery for prostate cancer, 98 percent of patients go home within 24 hours of the operation and major complications are less than 2 percent, according to Mani Menon, M.D., director of Henry Ford’s Vattikuti Urology Institute.

In selecting the study’s subjects, researchers relied on the Nationwide Inpatient Sample (NIS) maintained by the Agency for Healthcare Research and Quality under the U.S. Department of Health and Human Services. Read the full article here.

Conclusively, since it has been confirmed by studies( the above inclusive) that prostate cancer can be effectively treated with the Robot- Assisted approach when compared to invasive surgery, it is quite important that you consider your option now. If surgery is mandatory for you, talk to your doctor about your realistic expectations. It is also important that you are aware of the side effects of this treatment. The truth is that even with robot assisted radical prostatectomy; everyone may not be the right candidate for the procedure. So, consult in details with your doctor to ensure you can undergo this treatment for early detected cancer of the prostate.

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