Clinical Edge

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Cochrane on Surgical Approaches for Prostatectomy

Cochrane; 2017 Sep 12; Ilic, Evans, Allan, et al

Patients receiving laparoscopic radical prostatectomy (LRP) or robotic-assisted radical prostatectomy (RARP) experience less near-term postoperative pain and shorter hospitalizations than those undergoing open radical prostatectomy (ORP), according to a Cochrane review of 2 randomized controlled trials involving 446 men. There appear to be no other differences, however. Among the findings:

  • No differences in prostate cancer-related mortality, recurrence, or overall death rates were seen.
  • Men’s quality of life relative to urinary and sexual function was comparable.
  • Postoperative surgical complications also appeared to be similar.
  • Pain 1 to 7 days after surgery appeared to be lessened with LRP or RARP, but no difference in this regard was seen at 12 weeks.
  • Men who had LRP or RARP were more likely to have shorter hospital stays and require fewer blood transfusions.


Ilic D, Evans S, Allan C, Jung J, Murphy D, Frydenberg M. Laparoscopic and robotic-assisted versus open radical prostatectomy for the treatment of localised prostate cancer. Cochrane Database of Systematic Reviews. 2017, Issue 9. Art. No.: CD009625. doi:10.1002/14651858.CD009625.pub2.