67-6

32/93

neum made tamponade venous blood loss compared with RRP. Second, preoperative staged PC using Magnetic Resonance Imaging (MRI) have made it possible to revise RARP technology and optimize cancer control for locally advanced PC.12)Ficarra V et al. compared RARP with RRP urinary continence indicated that RARP had a better 12-mo urinary continence recovery than RRP.13) However, our results indicated that there were no statistical differences with regard to recovery UC in two groups. Not only age, BMI, prostate volume, etc., which have been pointed out to be related to factors affecting recovery UC, but also the length of the membranous urethra evalu-ated using MRI, it has been reported as a factor involved in recovery UC.14) Nguyen LN et al. reported that bilateral nerve sparing was associ-ated with a statistically significant decreased risk of postoperative urinary incontinence at 3 months compared to non-nerve sparing.15) In our study, many patients chose nerve-sparing in the RARP group, but few had bilateral nerve-sparing surgery, and most cases were unilaterally conserved, suggesting that there was no difference in recovery from incontinence. In order to obtain better recovery UC in the future, it is expected that RARP will enable surgical techniques to evaluate the structure around urethra by MRI and leave a thick and long membranous urethra.16)The present study had several limitations. First, the design was retrospective and observational at a single institution and single surgeon for RARP. Second, the follow-up period was relatively short in the RARP group. In conclusion, short operation time and low EBL, short LOS and few complications were confirmed by RARP rather than RRP, suggesting that the newly introduced RARP was minimally invasive surgery. Oncological outcome showed a significant difference with higher PSM rates in RRP group. No significant difference was found recovery from UC, and the short observation period was one of the factors, and it was considered that further accumu-lation was necessary.Not applicable.540The previous reports suggested that patient outcomes and surgical approach were mainly required to improve for an accurate characteriza-tion of complications.8) In our study patients under-went RARP had fewer hospital stay and complica-tions than RRP. The possible reason may be associated with lower EBL and less transfusion rate in RARP. Then a comprehensive classification of complications indicated that RRP had a higher incidence of rectal injury, wound infections, urinary leakage, and lymphocele. Although some reports have shortened the operation time of RRP, the results were short in patients who underwent RARP at our institution.8, 9) Stacey C. Carter et al. reported that operative times for RARP decreased over their contemporary study while remaining stable for RRP and higher RP surgeon volume was associated with shorter operative times and selec-tive referral to efficient.10) The ability to identify factors that influence the length of the operation has important implications for understanding surgeon learning curves. A short learning curve is one of the main advantages of the RARP, which makes it an interesting option for junior doctors and reduced operative time. Hugh J Lavery et al. reported that the “advanced learning curve” includes 100-300 cases, after which the operative time decreases to 165(75–200) minutes.11) At our institution, RARP was performed by a surgeon with more than 300 case experiences, so it is consid-ered that the operation time was short even in the initial experience.Overall, pathologic T stage did not differ signifi-cantly among patients who had undergone RARP and those who had undergone RRP, nor did pres-ence of T3 or higher disease. In our study, the PSM rates were higher than several study that reported of PSM of about 20-25% in other studies.(6) This is thought to be due to the higher proportion of cases with pT3 in both the RRP and RARP populations compared to previous reports. Jim C. Hu et al. reported that there were lower PSM rate with RARP versus RRP for men diagnosed with cT2a and cT1c PC, and the over cT3a PSM rate was also lower for RARP than for RRP.3) We have several reasons for the better surgical outcomes with RARP compared RRP. First, the improved RARP surgical margin status may be attributed to better visual-ization of the prostate capsule, and pneumoperito-Acknowledgments