A Critical Analysis of Surgical Curative Treatments Options in Localised Prostate Cancer: Open, Laparoscopic, and Robotassisted Radical Prostatectomy

Abstract

Purpose of this article is to critically review perioperative outcomes, positive surgical margin (PSM) rates, and functional outcomes of several large series and systemic review of retropubic radical prostatectomy (RRP), laparoscopic RP (LRP), and robot assisted radical prostatectomy (RARP) currently available in the literature. The quality of the available comparative studies was not excellent. LRP and RARP are attractive alternatives to open prostatectomy, offering the advantages of reduced blood loss and safe early catheter removal. Furthermore, the laparoscopic procedures proved to be safe oncologically. However the available data were not sufficient to prove the superiority of any surgical approach in terms of functional and oncological outcomes. Long-term follow-up and prospective randomised trials are required to compare oncological, functional results in terms of continence and potency. It is likely that one of the the most critical issue is the selection and education of the being better surgeon, rather than the surgical approach.