Outcomes and Complications of Robotic-assisted Laparoscopic Prostatectomy in a Community Hospital Setting.

Objective: To evaluate outcomes for 144 robotic-assisted laparoscopic prostatectomies (RALPs) conducted upon introduction of a robotic surgery program in a community hospital.

Methods: Patient data were reviewed for 144 patients who underwent RALP from January 2013 to February 2015. Complications and oncologic and functional outcomes were assessed. Student t test and analysis of variance were used to compare differences among study groups.

Results: Median age was 64 (IQR 60-68) and median prostate-specific antigen was 5.61 (interquartile range [IQR] 4.3-7.7). Stage pT2, pT3a, and 3b pathology was present at rates of 77%, 21%, and 8%, respectively. Median operative blood loss was 200 mL (IQR 150-300), median operative time was 1.75 hours (IQR 1.5-2.3), and median length of stay was 2 days (IQR 1-2). Overall, there were 9 complications (6.8%); 2 were classified as major and 7 as minor events. The overall positive surgical margin rate was 19%, with positive surgical margin rates of 11% and 46.8% in patients with pT2 and pT3 disease, respectively (P < .001). The overall biochemical recurrence rate at 12 months was 12.5% occurring in 10% and 20% of patients with pT2 and pT3 disease, respectively (P = .32). Continence success at 1, 6, and 12 months was 67%, 90%, and 93%, respectively. Potency success in men with normal to mild erectile dysfunction at baseline was 76% and 83% at 6 and 12 months, respectively.

Conclusion: RALP in this community hospital practice was both safe and effective. Complication rates and oncologic and functional outcomes in this study were commensurate with those reported by high volume centers.