Abstract
Objective
To compare outcomes of laparoscopic radical prostatectomy (LRP) performed in live
surgery versus daily routine LRP.
Methods
From January 2014 to June 2017, data from LRP performed at our Institution in live
broadcasting by 3 experienced laparoscopic surgeons during educational events were
collected. A 1:2 matching (according to BMI, comorbidities, NCCN risk groups, and
operating surgeon) was performed with the routine LRP patients collected in our prospectively-maintained
database. Chosen procedures were performed within the same time span by the same surgeons.
Data of interest were compared.
Results
Twenty-three live surgery LRPs were analyzed (Group A). Forty-six matched patients
were the controls (Group B). Groups were comparable at baseline. No differences were
found in perioperative data (operative time, blood loss, and intraoperative complications,
4.3% in both Groups) and postoperative complications. Particularly, 10 (43.5%) and
22 patients (47.8%) did not report complications (Group A vs B, respectively, P = .54). The majority of complications were Clavien 1-2, with 2 patients per Group
requiring blood transfusion. Overall positive surgical margins rate was 26.1%. It
was significantly higher in Group A (43.5% vs 17.4%; P = .02), but no differences were found in the number of patients who relapsed, who
needed radiotherapy or androgen deprivation therapy within a median follow-up of 25
months in both Groups. No differences were found regarding functional data. Limitations
include a low sample size and limited follow-up.
Conclusion
LRP has similar perioperative outcomes when performed in either live surgery or daily
routine setting. We underline the higher positive surgical margins rate after live
surgeries that should increase the awareness before embarking on it.
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Article info
Publication history
Published online: October 08, 2018
Accepted:
September 24,
2018
Received:
July 17,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
