By: Charlie Schmidt
It has been greater than ten years since robot-assisted radical prostatectomy got here on the scene for the treatment of localized prostate cancer. Its use is skyrocketing, driven partially by direct-to-consumer promoting and competition amongst hospitals. About two-thirds of all radical prostatectomies performed within the United States at the moment are performed with robotic assistance. Thanks to the hype, many men with prostate cancer imagine they are going to have higher results with robot-assisted prostate surgery than traditional open surgery. But to this point, studies comparing the 2 methods haven't supported this.
Robot-assisted surgery was designed to help surgeons in performing quite a lot of operations. Instead of moving an instrument directly, the surgeon manipulates controls that guide the robot to maneuver it. In theory, a robot can perform some actions more easily and accurately than a surgeon.
A newer comparative study produced similarly ambiguous results. The bottom line is that good results depend more on the experience of the surgeon than on the precise method he uses to remove the cancerous prostate.
Consistent results
An international team of researchers analyzed data from the US Surveillance, Epidemiology, and End Results database on nearly 6,000 men who were treated with robotic or open surgery between October 2008 and December 2009. This database provides probably the most comprehensive statistics available on cancer incidence. Diagnosis, first course of treatment, demographics, treatment follow-up, and more.
The researchers compared how men differed when it comes to a lot of complications 30 and 90 days after surgery. After adjusting for socioeconomic status, tumor grade, stage, and other aspects, the study authors found that:
- Postoperative complications and readmission rates were similar at each 30 and 90 days.
- But men who had robot-assisted surgery had higher risks of genitourinary and miscellaneous medical complications 30 and 90 days after surgery.
Based on their findings, published in Journal of Clinical Oncologythe authors concluded that robot-assisted prostate surgery can't be described as a protected procedure, but additionally they emphasized that it's protected based on the burden of evidence to this point.
New discoveries are consistent with this. A historical study published in Journal of the American Medical Association In 2009 For this effort, researchers reported that men treated with the robotic approach had shorter hospital stays and fewer respiratory and miscellaneous surgical complications than men treated with open surgery. But men who underwent robot-assisted surgery also had more genitourinary complications and better rates of incontinence and erectile dysfunction.
latest Journal of Clinical Oncology The study updates the 2009 comparison with latest data collected after robot-assisted prostatectomy became more widely used. But it also has some drawbacks. The men within the study had a mean age of 69 years at diagnosis, when surgical risks are high no matter technique. This means the outcomes might not be relevant to young men with prostate cancer, the authors cautioned A companion editorial. And given the limited follow-up, the study couldn't tell whether one method was higher than one other at controlling cancer over time.
“Buyer beware” is the message for men who select surgery after a diagnosis of localized prostate cancer, the message is buyer beware. “Robotic techniques are too small to draw clear conclusions about their overall effectiveness in controlling cancer,” says Dr. Garnick. “I believe patient satisfaction is comparable for each selections, so long as the relative pros and cons are discussed well ahead of time. A person should select one approach over the opposite along with his eyes open. needs to be done with