A comparative analysis of the efficacy of robotic vs. laparoscopic radical prostatectomy: a propensity score matching cohort study

Abstract:

Objective To compare the efficacy of robot-assisted vs. laparoscopic radical prostatectomy.Methods A retrospective analysis was performed on the clinical data of patients with prostate cancer（253 patients undergoing robot-assisted radical prostatectomy and 148 patients undergoing laparoscopic radical prostatectomy） in the Department of Urology in The First Affiliated Hospital of Chongqing Medical University between January 2017 and December 2022. The two groups were compared for positive surgical margins，length of hospital stay，and hospital fees after the baseline characteristics of the two groups had been matched and balanced using propensity scores.Results Multivariate logistic analyses showed that the odds ratio（OR） of positive surgical margins for robot-assisted surgery（compared with laparoscopic surgery） was 1.17（OR=1.17，95%CI=0.61-2.25，P=0.640）. The length of hospital stay was 13.5（10，17） days in the robot-assisted group and 13（10，18） days in the laparoscopic group，showing no significant difference between the two groups（P=0.927）. The total hospital fee was 72 695（65 479，78 623） Yuan in the robot-assisted group and 46 045（40 367，63 149） Yuan in the laparoscopic group，showing a significant difference（P<0.001）.Conclusion In comparison to laparoscopic radical prostatectomy，robot-assisted surgery does not offer any advantage in reducing patients’ length of hospital stay and incidence of positive surgical margins while adding extra medical expenses.