A new method for posterior pelvic reconstruction with autologous tissue in robot-assisted radical prostatectomy

Autor: Mkrtich S. Mosoyan, Denis A. Shelipanov, Dmitriy A. Fedorov, Nadezhda A. Aysina, Artem A. Vasil'ev
Rok vydání: 2022
Zdroj: Urology reports (St. - Petersburg). 12:33-40
ISSN: 2687-1416
2225-9074
DOI: 10.17816/uroved89659
Popis: BACKGROUND: Despite the improvement of surgical techniques and a significant improvement in the functional results of surgical interventions for prostate cancer urinary incontinence after radical prostatectomy remains the most important factor that negatively affects the quality of life of patients. AIM: Evaluation of the effectiveness and safety of a new technique for posterior reconstruction using autologous tissue an endopelvic fascia flap in robot-assisted radical prostatectomy. MATERIALS AND METHODS: 28 patients with localized prostate cancer who underwent modified robot-assisted radical prostatectomy at one medical center were included in the study. During the operation after removal of the prostate a posterior reconstruction of the small pelvis was performed by excising a flap of the endopelvic fascia on one side, placing it behind the bladder neck and urethrocystoanastomosis, followed by fixing this flap to a similar structure on the opposite side in the form of a loop, strengthening the anastomosis from behind. The main intraoperative parameters, oncological and functional results were evaluated. RESULTS: Analysis of the results of the study confirmed the high efficiency of the proposed surgical technique. The average operation duration was 145 min (120170 min), average console time was 68 min (55102 min), the average duration of the posterior reconstruction stage was 6 min (3.58.5 min). Average intraoperative blood loss was 55 ml (25175 ml). The urethral catheter was removed on the 7th day after the operation in all patients. During surgery there were no conversions and any complications of IIIV groups according to the Clavien Dindo classification. Immediate urinary continence was noted in 23 (82.1%) patients (82,1%), early urinary continence was noted in 26 (92.8%) patients. CONCLUSIONS: The results of the study showed that the use of a new technique for posterior reconstruction in robot-assisted radical prostatectomy using endopelvic fascia flaps is effective and safe, showing good early functional results, in particular, immediate urinary continence without compromising oncological outcomes.
Databáze: OpenAIRE
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