Featured Research

from universities, journals, and other organizations

Minimally Invasive Radical Prostatectomy Shows Advantages, But Also Certain Complications

Date:
October 14, 2009
Source:
JAMA and Archives Journals
Summary:
New research indicates that the use of minimally invasive procedures for radical prostatectomy, which have increased significantly in recent years, may shorten hospital stays and decrease respiratory and surgical complications, but may also result in an increased rate of certain complications, including incontinence and erectile dysfunction, according to a new study.

New research indicates that the use of minimally invasive procedures (including the use of robotic assistance) for radical prostatectomy, which have increased significantly in recent years, may shorten hospital stays and decrease respiratory and surgical complications, but may also result in an increased rate of certain complications, including incontinence and erectile dysfunction, according to a study in the October 14 issue of JAMA, a theme issue on surgical care.

Jim C. Hu, M.D., M.P.H., of Brigham and Women's Hospital, Boston, presented the findings of the study at a JAMA media briefing in Chicago.

Minimally invasive radical prostatectomy (MIRP), in particular with the use of robotic assistance, has increased from 1 percent to 40 percent of all radical prostatectomies from 2001 to 2006, according to background information in the article. But this rapid increase has occurred despite limited data on outcomes and greater costs compared with open retropubic radical prostatectomy (RRP; surgery in which an incision is made in the lower abdomen to remove the prostate, which is located in the pelvis behind the pubic bone).

"Moreover, the widespread direct-to-consumer advertising and marketed benefits of robotic-assisted MIRP in the United States may promote publication bias against studies that detail challenges and suboptimal outcomes early in the MIRP learning curve. Until comparative effectiveness of robotic-assisted MIRP can be demonstrated, open RRP, with a 20-year lead time for dissemination of surgical technique relative to MIRP, remains the gold standard surgical therapy for localized prostate cancer," the authors write.

Dr. Hu and colleagues assessed the outcomes for men with prostate cancer who underwent MIRP (n = 1,938) vs. RRP (n = 6,899), using U.S. Surveillance, Epidemiology, and End Results Medicare linked data. During the study period, the use of MIRP increased almost 5-fold, from 9.2 percent in 2003 to 43.2 percent in 2006-2007.

After analyses, the researchers found that men undergoing MIRP vs. RRP experienced shorter hospital length of stay (median [midpoint], 2.0 vs. 3.0 days), were less likely to receive transfusions (2.7 percent vs. 20.8 percent), and were at lower risk of postoperative respiratory complications (4.3 percent vs. 6.6 percent) and miscellaneous surgical complications (4.3 percent vs. 5.6 percent).

"However, men undergoing MIRP vs. RRP experienced more genitourinary complications [involving the genital and urinary organs or their functions; 4.7 percent vs. 2.1 percent) and were more often diagnosed as having incontinence and erectile dysfunction. The need for additional cancer therapies was similar by surgical approach," the authors write.

The researchers also found that greater receipt of MIRP vs. RRP was associated with living in areas of higher socioeconomic status based on education and income, and that this may be the result of a "highly successful robotic-assisted MIRP marketing campaign disseminated via the Internet, radio, and print media channels likely to be frequented by men of higher socioeconomic status."

"In light of the mixed outcomes associated with MIRP, our finding that men of higher socioeconomic status opted for a high-technology alternative despite insufficient data demonstrating superiority over an established gold standard may be a reflection of a society and health care system enamored with new technology that increased direct and indirect health care costs but had yet to uniformly realize marketed or potential benefits during early adoption," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Jim C. Hu; Xiangmei Gu; Stuart R. Lipsitz; Michael J. Barry; Anthony V. D'Amico; Aaron C. Weinberg; Nancy L. Keating. Comparative Effectiveness of Minimally Invasive vs Open Radical Prostatectomy. JAMA, 2009; 302 (14): 1557-1564 [link]

Cite This Page:

JAMA and Archives Journals. "Minimally Invasive Radical Prostatectomy Shows Advantages, But Also Certain Complications." ScienceDaily. ScienceDaily, 14 October 2009. <www.sciencedaily.com/releases/2009/10/091013112507.htm>.
JAMA and Archives Journals. (2009, October 14). Minimally Invasive Radical Prostatectomy Shows Advantages, But Also Certain Complications. ScienceDaily. Retrieved August 28, 2014 from www.sciencedaily.com/releases/2009/10/091013112507.htm
JAMA and Archives Journals. "Minimally Invasive Radical Prostatectomy Shows Advantages, But Also Certain Complications." ScienceDaily. www.sciencedaily.com/releases/2009/10/091013112507.htm (accessed August 28, 2014).

Share This




More Health & Medicine News

Thursday, August 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Treadmill 'trips' May Reduce Falls for Elderly

Treadmill 'trips' May Reduce Falls for Elderly

AP (Aug. 28, 2014) Scientists are tripping the elderly on purpose in a Chicago lab in an effort to better prevent seniors from falling and injuring themselves in real life. (Aug.28) Video provided by AP
Powered by NewsLook.com
Mini Pacemaker Has No Wires

Mini Pacemaker Has No Wires

Ivanhoe (Aug. 27, 2014) Cardiac experts are testing a new experimental device designed to eliminate major surgery and still keep the heart on track. Video provided by Ivanhoe
Powered by NewsLook.com
After Cancer: Rebuilding Breasts With Fat

After Cancer: Rebuilding Breasts With Fat

Ivanhoe (Aug. 27, 2014) More than 269 million women are diagnosed with breast cancer each year. Many of them will need surgery and radiation, but there’s a new simple way to reconstruct tissue using a patient’s own fat. Video provided by Ivanhoe
Powered by NewsLook.com
Blood Clots in Kids

Blood Clots in Kids

Ivanhoe (Aug. 27, 2014) Every year, up to 200,000 Americans die from a blood clot that travels to their lungs. You’ve heard about clots in adults, but new research shows kids can get them too. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins