Robotic prostatectomy curbs blood loss

NEW YORK (Reuters Health) - Blood loss is significantly lower in robotic-assisted laparoscopic prostatectomy than in open radical prostatectomy, a new study shows.

"There were few transfusions in both groups, but the percentage of patients requiring transfusion was significantly lower in the robotic group (0.8%) compared to the open group (3.4%)," one of the authors, Dr. Daniel A. Barocas of Vanderbilt University Medical Center, Nashville, Tennessee, told Reuters Health by email.

Dr. Barocas and his colleagues studied 830 men who had robotic-assisted laparoscopy and 414 who had open radical retropubic surgery.

In a February 11th online paper in BJU International, the researchers report that median blood loss was 100 mL with laparoscopy vs 450 with open surgery (p < 0.001). The robotic surgery group also had a significantly smaller median change in hematocrit (7% versus 10%, p < 0.001) in addition to the lower transfusion rate mentioned by Dr. Barocas.

Univariate analysis showed the significant predictors of transfusion to be the approach used, an estimated blood loss of at least 500 mL, and a hematocrit change of 10% or more.

In an exploratory multivariate model, robotic-assisted laparoscopic surgery was the only significant predictor of a reduced need for transfusion (odds ratio, 0.23).

"Lower blood loss during robotic prostatectomy may improve visualization during surgery," Dr. Barocas said. "In addition, lower blood loss and transfusion rate may contribute to a speedier recovery after surgery."

Copyright © 2010 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.