The question: For some diseases, minimally invasive surgery has been shown to have advantages over traditional, open surgery. Might that be the case when the prostate gland needs to be removed?
This study: It analyzed data on 8,837 men, 65 and older, who had a radical prostatectomy; 22 percent had minimally invasive laparoscopic surgery, with or without robotic assistance, and the others had open surgery, with the gland removed through an incision in the abdomen (retropubic prostatectomy). Men who had laparoscopic surgery stayed in the hospital an average of two rather than three days, got fewer blood transfusions and had fewer respiratory and other postoperative complications than those who had open surgery. But they had double the genital and urinary-tract complications and were more likely to have incontinence or erectile dysfunction 18 months later. There was little difference between the groups in the need for additional cancer treatment.
Who may be affected? Men who are having their prostate gland removed because of cancer. In the United States, men have about a 1-in-6 chance of developing prostate cancer. However, the survival rate at five years is nearly 100 percent, and it is greater than 90 percent at 10 years.
Caveats: The study did not include men who had perineal prostatectomy (where the incision is between the scrotum and anus); their results could be different. Procedures performed by less-experienced surgeons also might yield different results. The study did not compare either type of surgery with other treatment options like radiation or monitoring the prostate for changes (called watchful waiting).
Find this study: Oct. 14 issue of the Journal of the American Medical Association.
Learn more: www.mayoclinic.com and www.prostatecancerfoundation.org.
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