Session: MP61: Prostate Cancer: Localized: Surgical Therapy II
MP61-09: Patient-reported outcomes of a randomized controlled trial comparing supraumbilical versus transumbilical camera port in robotic assisted laparoscopic prostatectomy
Introduction: Supraumbilical camera port (SU) has generally been used in robotic assisted laparoscopic prostatectomy (RALP). Transumbilical camera port (TU) may have cosmetic advantages. In this study, we compared the patient-reported outcomes including cosmetic outcomes, postoperative pain and QOL. Methods: This study was registered with UMIN-Clinical Trials Registry (protocol ID: UMIN000035259). Between January 2019 and February 2022, 98 patients with localized prostate cancer were enrolled in this study and randomized to SU and TU group (n=50, 48, respectively) based on prostate volume, Gleason score and BMI. In SU group, camera port was inserted through a 12 mm midline incision at 2cm above umbilicus with Veress needle access, and in TU group, through the umbilicus with Hasson open technique. Body image questionnaire (BIQ), cosmetic scale (CS) on postoperative day (POD) 7, pain score (numeric rating scale; NRS) on POD 1 and 7 and QOL questions (MOS 36 Item short form health survey; SF-36) in postoperative month 3 were collected and compared between the groups. Results: Demographic data and clinical outcomes were comparable between both groups. BIQ (8-44: 8-least satisfied, 44-most satisfied; median, SU vs. TU, 33 vs. 35, p = 0.2254) and Cosmetic Score (2-24: 2-least satisfied, 24-most satisfied; median, SU vs. TU, 17 vs. 18, p = 0.2743) were similar in both groups. NRS on POD 1 (0-10: 0-no pain, 10-worst pain; median (IQR), SU vs. TU, 3 (2 - 4) vs. 3 (2.25 - 5), p = 0.0165) was significantly worse in the TU group (Figure. 1), but NRS on POD 7 (median (IQR), SU vs. TU, 0 (0 - 1) vs. 1 (0 - 1), p = 0.5252) was not. SF-36 (22-least satisfied, 100-most satisfied; SU vs. TU, 77.6 vs. 80.4, p =0.4035) was similar in both groups. Conclusions: Patients who underwent RALP with TU did not report cosmetic advantage compared to patients with SU, but they reported significantly worse pain on POD 1. The port placement in RALP should be considered based on not only cosmetic outcomes but postoperative pain. SOURCE OF Funding: None
