Peritoneal Distraction Technique to Reduce Symptomatic Lymphoceles after Retzius-Sparing Robot-Assisted Radical Prostatectomy.

Autor:	Mathew JE; Department of Urology, Aster Medcity, Kochi, Kerala, India., Sodhi BS; Department of Urology, Aster Medcity, Kochi, Kerala, India., Kaddu D; Department of Urology, Aster Medcity, Kochi, Kerala, India., Boppanna VB; Department of Urology, Aster Medcity, Kochi, Kerala, India., Ramaprasad MK; Department of Urology, Aster Medcity, Kochi, Kerala, India., Prabhakaran S; Department of Urology, Aster Medcity, Kochi, Kerala, India., Kishore TA; Department of Urology, Aster Medcity, Kochi, Kerala, India.
Jazyk:	angličtina
Zdroj:	Saudi journal of medicine & medical sciences [Saudi J Med Med Sci] 2024 Jul-Sep; Vol. 12 (3), pp. 230-235. Date of Electronic Publication: 2024 Jun 20.
DOI:	10.4103/sjmms.sjmms_634_23
Abstrakt:	Background: In Retzius-sparing robot-assisted radical prostatectomy (RARP), lymphocele formation is a troublesome complication. The use of peritoneal flaps has emerged as a promising novel technique to tackle this complication. We explored this technique by suturing both the medial peritoneal flaps to each other and keeping them distracted so that the lymphadenectomy beds are left wide open. Objective: To assess the efficacy of our peritoneal distraction technique on lymphocele rates following Retzius-sparing RARP. Materials and Methods: This retrospective study included patients with localized prostate carcinoma who underwent Retzius-sparing RARP with standard pelvic lymph node dissection between May 2014 and September 2022 at Aster Medcity, Kochi, India. Based on the use of the technique, patients were divided into two groups: peritoneal distraction and closed groups. Both groups were matched using the propensity scoring method in a 1:1 ratio. Results: A total of 272 patients were included, of which 89 (32.7%) belonged to the peritoneal distraction group. Although the overall incidence of lymphocele between the two groups were comparable, none of the patients in the peritoneal distraction group required any intervention for lymphocele management, as opposed to 7 patients from the closed group (3.9%; P = 0.015). No significant association was found between lymphocele formation and serum prostate-specific antigen level, Gleason score, and the number of lymph nodes harvested. Conclusions: This study found that peritoneal distraction stitch is a simple and effective technique to reduce the incidence of symptomatic lymphocele that require intervention after Retzius-sparing RARP. Competing Interests: None. (Copyright: © 2024 Saudi Journal of Medicine & Medical Sciences.)
Databáze:	MEDLINE
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