Open, laparoscopic prostate surgery showed similar rates of postoperative mortality, morbidity

Patients undergoing surgery to treat prostate cancer had similar rates of postoperative morbidity and mortality with laparoscopic and open radical prostatectomy. However, laparoscopic prostatectomy was associated with a 35% shorter hospital stay and lower bladder urethral obstruction rate.

“All men considering radical prostatectomy should be clearly informed about the differences between the two techniques and similarities in their expected outcomes and make treatment decisions in collaboration with an experienced surgeon,” researchers wrote.

The researchers compared the outcomes of open retropubic radical prostatectomy vs. laparoscopic radical prostatectomy in 5,923 men aged 66 years or older who underwent a procedure for localized prostate cancer between 2003 and 2005. Data were pooled from the SEER cancer registry.

Eighty-two percent of men (n=4,858) underwent open radical prostatectomy and 18% (n=1,065) underwent laparoscopic radical prostatectomy.

No differences were found in the rate for general medical or surgical complications (OR=0.93; 95% CI, 0.77–1.14), genitourinary or bowel complications (OR=0.96; 95% CI, 0.76–1.22), or in postoperative radiation or androgen deprivation (OR=0.8; 95% CI, 0.6–1.08).

However, laparoscopic prostatectomy was associated with a 35% shorter hospital stay (P<.0001) and a lower bladder urethral obstruction rate (OR=0.74; 95% CI, 0.58–0.94) when compared with open radical prostatectomy.

Further, surgeon volume for laparoscopy was inversely associated with hospital stay and the odds for any genitourinary complication. The only significant predictors for complications were age, comorbidity and surgeon volume.

Lowrance WT. J Urol. 2010;183:1366-1372.