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Journals / Batı Karadeniz Tıp Dergisi / 2026 / Cilt: 10 Sayı: 2

Transitioning from open to laparoscopic radical prostatectomy: Safety and feasibility during the learning curve

Açık cerrahiden laparoskopik radikal prostatektomiye geçiş: Öğrenme eğrisi sürecinde güvenlik ve uygulanabilirlik

Yavuz Mert Aydın(Zonguldak Bulent Ecevit University, Faculty of Medicine, Department of Urology, Zonguldak, Türkiye)0000-0002-6287-6767
Yiğit Atasoy(Zonguldak Bulent Ecevit University, Faculty of Medicine, Department of Urology, Zonguldak, Türkiye)0009-0005-6205-9475
Reha Girgin(Zonguldak Bulent Ecevit University, Faculty of Medicine, Department of Urology, Zonguldak, Türkiye)0000-0003-1132-8629
Necmettin Aydın Mungan(Zonguldak Bulent Ecevit University, Faculty of Medicine, Department of Urology, Zonguldak, Türkiye)0000-0002-1985-4212
Pages
211–219
Publication Date
2026-08-31
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: LRP can be safely adopted during the learning curve without compromising early oncological or functional outcomes.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: This study aimed to analyze the challenges encountered during the transition from open retropubic radical prostatectomy (RRP) to laparoscopic radical prostatectomy (LRP) at a long-standing center of open RRP experience and to evaluate surgical, tumor-related, and functional outcomes during the adaptation period.
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Key Findings & Data:Material and Methods: 12 LRP and 21 RRP patients operated between January-June 2025 were prospectively collected and retrospectively analyzed.
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Conclusion & Impact:Conclusion: LRP can be safely adopted during the learning curve without compromising early oncological or functional outcomes.
🔬Design:Araştırma Makalesi
📍Scope:2025 Verileri
⚙️Variables:Laparoskopik radikal prostatektomi · retropubik radikal prostatektomi · öğrenme eğrisi

Abstract

Aim: This study aimed to analyze the challenges encountered during the transition from open retropubic radical prostatectomy (RRP) to laparoscopic radical prostatectomy (LRP) at a long-standing center of open RRP experience and to evaluate surgical, tumor-related, and functional outcomes during the adaptation period. Material and Methods: 12 LRP and 21 RRP patients operated between January-June 2025 were prospectively collected and retrospectively analyzed. Perioperative parameters, pathological outcomes, and functional results were analyzed. Continence was assessed using ICIQ-SF scores and defined as score ≤5 or complete absence of pad use. Potency was evaluated using IIEF-5 scores, with potency defined as score ≥17. Complications were stratified according to Satava and Clavien-Dindo systems. Results: Baseline demographic and clinicopathological characteristics were comparable. The LRP group demonstrated significantly reduced estimated blood loss (660.5±221.4 vs 1100±528.1 mL, p=0.021), lower transfusion rate (25.0% vs 71.4%, p=0.027), shorter drain removal time (median 2 vs 4 days, p=0.002), and reduced length of hospital stay (median 3 vs 4 days, p=0.006). Perioperative complications were similar (16.7% vs 9.5%, p=0.708). Positive surgical margin rates (33.3% vs 66.7%, p=0.137) and biochemical recurrence rates (8.3% vs 4.8%, p=0.685), showed no significant differences. The LRP group achieved significantly higher early continence at 1st month (33.3% vs 4.8%, p=0.029) and higher IIEF-5 scores at 3rd (10.5 vs 8, p=0.020) and 6th months (13.5 vs 9, p=0.030). Conclusion: LRP can be safely adopted during the learning curve without compromising early oncological or functional outcomes.

Özet

Amaç: Bu çalışma, uzun yıllardır açık retropubik radikal prostatektomi (RRP) deneyimine sahip bir merkezde açık cerrahiden laparoskopik radikal prostatektomiye (LRP) geçiş sırasında karşılaşılan zorlukları analiz etmeyi ve erken öğrenme eğrisi döneminde perioperatif, onkolojik ve fonksiyonel sonuçları değerlendirmeyi amaçladı. Gereç ve Yöntemler: Ocak–Haziran 2025 tarihleri arasında radikal prostatektomi uygulanan 12 LRP ve 21 RRP hastası prospektif olarak kaydedildi ve retrospektif olarak analiz edildi. Perioperatif parametreler, patolojik sonuçlar ve fonksiyonel bulgular incelendi. Kontinans, ICIQ-SF skorları kullanılarak değerlendirildi ve skor ≤5 olması veya tamamen ped kullanılmaması kontinans olarak tanımlandı. Potens, IIEF-5 skorları ile değerlendirildi ve skorun ≥17 olması potens olarak kabul edildi. Komplikasyonlar Satava ve Clavien-Dindo sınıflama sistemlerine göre değerlendirildi. Bulgular: Başlangıç demografik ve klinikopatolojik özellikler benzerdi. LRP grubunda tahmini kan kaybı anlamlı olarak daha düşük (660.5±221.4’e karşı 1100±528.1 mL, p=0.021), transfüzyon oranı daha az (%25.0’a karşı %71.4, p=0.027), dren çekilme süresi daha kısa (medyan 2’ye karşı 4 gün, p=0.002) ve hastanede kalış süresi daha kısa bulundu (medyan 3’e karşı 4 gün, p=0.006). Perioperatif komplikasyon oranları benzerdi (%16,7’ye karşı %9,5, p=0,708). Pozitif cerrahi sınır oranları (%33.3’e karşı %66.7, p=0.137) ve biyokimyasal nüks oranları (%8.3’e karşı %4.8, p=0.685) dahil olmak üzere patolojik sonuçlar açısından anlamlı fark saptanmadı. LRP grubunda 1. ayda erken kontinans oranı anlamlı derecede daha yüksek bulundu (%33,3’e karşı %4.8, p=0,029). Ayrıca 3. ayda (10.5’e karşı 8, p=0.020) ve 6. ayda (13.5’e karşı 9, p=0.030) IIEF-5 skorları daha yüksek saptandı. Sonuç: LRP, öğrenme eğrisi sürecinde erken onkolojik veya fonksiyonel sonuçlardan ödün vermeden güvenle uygulanabilir.

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Cite This Article

Aydın, Y. M., Atasoy, Y., Girgin, R., Mungan, N. A. (2026). Transitioning from open to laparoscopic radical prostatectomy: Safety and feasibility during the learning curve. Batı Karadeniz Tıp Dergisi, Cilt: 10 Sayı: 2, 211–219. https://doi.org/10.29058/mjwbs.1891824

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