Peritoneal Flap Following Lymph Node Dissection in Robotic Radical Prostatectomy: A Novel "Bunching" Technique.

Autor: Gamal A; AdventHealth Global Robotics Institute, Celebration, FL 34747, USA., Moschovas MC; AdventHealth Global Robotics Institute, Celebration, FL 34747, USA.; Urology Department, University of Central Florida (UCF), Orlando, FL 32816, USA., Jaber AR; AdventHealth Global Robotics Institute, Celebration, FL 34747, USA., Saikali S; AdventHealth Global Robotics Institute, Celebration, FL 34747, USA., Sandri M; Big and Open Data Innovation Laboratory (BODaI-Lab) and Data Methods and Systems Statistical, 25123 Brescia, Italy., Patel E; Stanford University, Palo Alto, CA 94305, USA., Patel E; AdventHealth Global Robotics Institute, Celebration, FL 34747, USA., Rogers T; AdventHealth Global Robotics Institute, Celebration, FL 34747, USA., Patel V; AdventHealth Global Robotics Institute, Celebration, FL 34747, USA.; Urology Department, University of Central Florida (UCF), Orlando, FL 32816, USA.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Apr 18; Vol. 16 (8). Date of Electronic Publication: 2024 Apr 18.
DOI: 10.3390/cancers16081547
Abstrakt: Background: Pelvic lymph node dissection (PLND) is recommended while performing robot-assisted radical prostatectomy (RARP) for patients with localized intermediate or high-risk prostate cancer. However, symptomatic lymphoceles can occur after surgery, adding significant morbidity to patients. Our objective is to describe a novel Peritoneal Bladder Flap Bunching technique (PBFB) to reduce the risk of clinically significant lymphoceles in patients undergoing RARP and PLND.
Methods: We evaluated 2267 patients who underwent RARP with PLND, dividing them into two groups: Group 1, comprising 567 patients who had the peritoneal flap (PBFB), and Group 2, comprising 1700 patients without the flap; propensity score matching carried out at a 1:3 ratio. Variables analyzed included estimated blood loss (EBL), operative time, postoperative complications, lymphocele formation, and the development of symptomatic lymphocele.
Results: The two groups exhibited similar preoperative characteristics after matching. There was no statistically significant difference in the occurrence of lymphoceles between the flap group and the non-flap group, with rates of 24% and 20.9%, respectively ( p = 0.14). However, none of the patients in the flap group (0%) developed symptomatic lymphoceles, whereas 2.2% of patients in the non-flap group experienced symptomatic lymphoceles ( p = 0.01).
Conclusion: We have demonstrated a modified technique for a peritoneal flap (PBFB) with the initial elimination of postoperative symptomatic lymphoceles and promising short-term outcomes.
Databáze: MEDLINE
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