Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Fewer complications, better outcomes with robot-assisted prostate cancer surgery

24.04.2012
Robot-assisted surgery is now both more common and far more successful than radical "open" surgery to treat prostate cancer in the United States, according to a new Henry Ford Hospital study published in the current issue of the medical journal European Urology.

The research, led by scientists at Henry Ford Hospital's Vattikuti Urology Institute (VUI), is the first to compare in a nationwide population sample the results of robot-assisted radical prostatectomy (RARP) to the standard surgical procedure, open radical prostatectomy (ORP).

The researchers found, based n a representative 20 percent sample of the U.S. that:

19,278 patients underwent RARP or ORP in 647 medical institutions between October 2008 and December 2009.

Of those, 11,889 underwent RARP and 7,389 underwent ORP.

More RARPs were performed at teaching institutions in urban locations, and a higher proportion of RARPs were performed at high-volume hospitals.

RARP patients were less likely than ORP patients to need a blood transfusion, less likely to have a prolonged hospital stay, and less like to suffer complications during or after surgery, including cardiac, respiratory, and vascular problems.

ORP involves opening the lower abdomen with a long incision, and removing the entire diseased prostate gland and some surrounding tissue in the hope of preventing the cancer from spreading to other parts of the body.

A similar procedure, known as RARP, is done through tiny incisions using minimally invasive laparoscopic surgery. Henry Ford Hospital pioneered the use of robots to assist surgeons in this delicate procedure, and the new study confirms earlier Henry Ford findings that RARP is now the most common technique in the United States for treating localized prostate cancer.

Prostate cancer is the most common "solid organ" malignancy and the second leading cause of cancer death in U.S. men. Radical prostatectomy became the standard treatment after it was shown that the surgery resulted in higher survival rates than "watchful waiting."

But in the past 10 years, "we've seen a significant trend toward the use of minimally invasive approaches to RP for the treatment of prostate cancer, particularly in the U.S.," says Quoc-Dien Trinh, M.D., a fellow at VUI and lead author of the study.

"While this evolution has been controversial, there have been few comparative studies. Most of those looked only at single institutions or single surgeons, and they were of poor evidentiary quality."

Most significantly, the new study found "superior" results with RARP in virtually every outcome studied, including the amount of necessary blood transfusions, complications during and after surgery, and length of hospital stay.

At Henry Ford, which did much of the original work on robotic surgery for prostate cancer, 98 percent of patients go home within 24 hours of the operation and major complications are less than 2 percent, according to Mani Menon, M.D., director of Henry Ford's Vattikuti Urology Institute.

In selecting the study's subjects, researchers relied on the Nationwide Inpatient Sample (NIS) maintained by the Agency for Healthcare Research and Quality under the U.S. Department of Health and Human Services.

In another first-of-a-kind study published in European Urology in February 2011, Henry Ford urologists and epidemiologists determined that RARP is safe over the long term, with a complication rate of less than 10 percent. That followed another Henry Ford study that found nearly 87 percent of patients whose cancerous prostates were removed by robot-assisted surgery had no recurrence of the disease after 5 years.

That was followed in September 2011 by another Henry Ford-led international study that found prostate cancer patients who undergo radical prostatectomy get better results at teaching hospitals than at non-academic medical institutions.

The authors of the new research paper noted that while their study did not examine the disparities in patient access to robotic surgery, they did find significant differences between RARP and ORP patients:

More of them were white.
They had fewer additional diseases or disorders.
They were more likely to get their surgery at urban academic centers.
"This is significant not only because better surgical outcomes are expected at academic centers," says Dr. Trinh, "but other recent data show that patients without private insurance – those covered by Medicare or Medicaid, or self-paid – are more likely to have complications during and after surgery, and need much more time in the hospital."

Funding: Vattikuti Urology Institute at Henry Ford Hospital.

Article: http://europeanurology.com/article/S0302-2838(11)01411-4/fulltext

Dwight Angell | EurekAlert!
Further information:
http://www.hfhs.org

Further reports about: Fewer ORP RARP prostate cancer radical prostatectomy robotic surgery urology

More articles from Health and Medicine:

nachricht Hot cars can hit deadly temperatures in as little as one hour
24.05.2018 | Arizona State University

nachricht 3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Powerful IT security for the car of the future – research alliance develops new approaches

The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.

Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...

Im Focus: Molecular switch will facilitate the development of pioneering electro-optical devices

A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.

The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

In focus: Climate adapted plants

25.05.2018 | Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

 
Latest News

In focus: Climate adapted plants

25.05.2018 | Event News

Flow probes from the 3D printer

25.05.2018 | Machine Engineering

Less is more? Gene switch for healthy aging found

25.05.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>