The early therapeutic efficacy of robot-assisted laparoscopic radical prostatectomy with combined anterior and posterior approach: a cohort study.

This study aims to compare the perioperative outcomes, postoperative urinary control rates, and positive surgical margin (PSM) rates of robot-assisted laparoscopic radical prostatectomy using a combined anterior and posterior approach (AP-RARP) with those of the Retzius-sparing (RS-RARP) and standard anterior (anterior-RARP) approaches in prostate cancer treatment. We collected and analyzed medical data from prostate cancer patients who underwent one of these three approaches. No statistically significant differences were observed in operative time, intraoperative blood loss, transfusion rates, anastomotic leakage, or postoperative infection rates among the groups. PSM rates were comparable across the three groups in patients with T2 stage disease, whereas AP-RARP and anterior-RARP demonstrated lower PSM rates compared to RS-RARP in patients with T3a stage disease. The RS-RARP group demonstrated lower immediate and 1-month postoperative continence rates than the AP-RARP and anterior-RARP groups. At 3 months postoperatively, continence rates in both RS-RARP and AP-RARP groups were lower than those observed in the anterior-RARP group, with no significant differences among the groups at 6 months postoperatively. In conclusion, AP-RARP appears to be a viable surgical option for prostate cancer treatment.