The First Comparison of Robotic and Open Surgery in Prostate Cancer

Prostate cancer is the second most common cancer among men in our country after lung cancer. Worldwide, approximately 1 million men develop it annually. The most common early-stage treatment is surgical removal of the prostate gland. Some patients develop urinary and sexual problems afterward. For every 3 men undergoing surgery, 1 experiences cancer recurrence.

With the development of Robot-Assisted Laparoscopic Prostatectomy (RALP) in the 2000s, robotic surgery spread rapidly in prostate cancer. The robot provides 3-dimensional, high-resolution images magnified 10-20 times. The surgeon controls robotic arms throughout the operation.

Differences in quality of life and cancer outcomes between robotic and open surgery have been debated. A prominent study published in the respected Lancet on 26 July found no quality-of-life difference from robotic prostate cancer surgery.

The study included 308 patients, randomly assigning 151 to robotic surgery and 151 to open surgery. For 12 weeks, urinary problems such as incontinence, painful urination or blood in urine, and sexual function, were followed. Analysis found no quality-of-life difference between groups.

Also;

• Although open-surgery patients stayed longer in hospital, both groups spent equal time away from work.
• Open surgery caused 3 times more blood loss. However, blood could be returned to the body during surgery.
• Robotic surgery patients had less pain and better quality of life for the first 6 weeks. By week 12., both groups had equal quality of life.

New surgical technologies certainly contribute to quality of life and prognosis. However, such studies show the need to evaluate newly developed techniques.

These findings represent only the first stage of a two-year study. Researchers noted that full assessment of urinary and sexual function after prostate surgery may take 3 years. Overall survival also requires long-term observation. Long-term effects therefore need evaluation.