Photo Credit: ALIOUI Mohammed Elamine

The following is a summary of “Transversal approach via a bladder neck and prostate combined longitudinal incision versus the standard approach of robotic-assisted radical prostatectomy for localized prostate cancer: a retrospective analysis,” published in the March 2024 issue of Oncology by Shen et al.

The utilization of the transversal approach for robotic-assisted radical prostatectomy via a bladder neck and prostate combined longitudinal incision (L-RALP) represents a novel surgical technique aimed at optimizing outcomes for patients diagnosed with resectable prostate cancer. In this retrospective analysis, a cohort of 669 patients with prostate cancer who underwent either L-RALP or the standard approach of robotic-assisted radical prostatectomy (S-RALP) between April 2016 and April 2020 was evaluated. Of these patients, 277 were included in the final analysis, with 151 undergoing S-RALP and 126 undergoing L-RALP. 

Notably, baseline characteristics were well-balanced between the two groups. Analysis revealed that patients in the S-RALP group experienced significantly shorter average surgical times than those in the L-RALP group (135.93 vs. 150.04 minutes; p < 0.001). However, intraoperative bleeding volume, rates of early postoperative complications, time to postoperative catheter removal, and hospital stays were comparable between the two groups. Moreover, there was no significant difference in biochemical recurrence rates at various follow-up time points. Importantly, patients undergoing L-RALP demonstrated superior urinary control function recovery compared to those undergoing S-RALP. Additionally, L-RALP recipients exhibited significantly better Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) scores, particularly regarding urinary control and total scores, at 6 weeks and 3, 6, 12, and 18 months postoperatively. In conclusion, both S-RALP and L-RALP were deemed safe and productive, with comparable long-term clinical outcomes in patients with resectable prostate cancer. 

However, L-RALP recipients demonstrated significantly improved postoperative outcomes, particularly in the urinary control and recovery period, underscoring the potential benefits of this innovative surgical approach in optimizing patient outcomes and enhancing the quality of life following radical prostatectomy.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12015-0