Asian Journal of Urology (Apr 2023)

Randomized controlled trial comparing open anterograde anatomic radical retropubic prostatectomy with retrograde technique

  • Fabricio B. Carrerette,
  • Daniela B. Rodeiro,
  • Rui T.F. Filho,
  • Paulo A. Santos,
  • Celso C. Lara,
  • Ronaldo Damião

Journal volume & issue
Vol. 10, no. 2
pp. 151 – 157

Abstract

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Objective: Radical prostatectomy is the recommended treatment for localized prostate cancer; however, it is an invasive procedure that can leave serious morbidity. Robot-assisted radical prostatectomy was introduced with the aim of reducing postoperative morbidity and facilitating rapid recovery compared to the traditional Walsh's open radical retropubic prostatectomy. Therefore, a protocol was developed to perform an open prostatectomy comparable to that performed by robotics, but without involving novel instrumentation. Methods: A total of 220 patients diagnosed with localized prostate cancer underwent radical prostatectomy. They were divided into two groups: anterograde technique (115 patients) and the retrograde method (105 patients). The study outcomes were observed 3 months after surgery. Results: No differences were found in terms of surgical time, hospital stay, and suction drainage. However, reduced bleeding was observed in the anterograde technique (p=0.0003), with rapid anastomosis duration (p=0.005). Among the patients, 60.9% undergoing the anterograde technique were continent 3 months after surgery compared to 42.9% treated by the retrograde method (p=0.007). Additionally, fewer complications in terms of the number (p=0.007) and severity (p=0.0006) were observed in the anterograde technique. Conclusion: The anterograde method displayed increased efficiency in reducing complications, compared to the retrograde technique.

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