Robot‐assisted radical perineal prostatectomy: a review of 95 cases

Autor:	Volkan Tugcu, Abdulmuttalip Simsek, Yunus Çolakoğlu, Mithat Ekşi, A.I. Tasci, Selcuk Sahin, İsmail Evren
Rok vydání:	2020
Předmět:	Male medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology Perineum 03 medical and health sciences Prostate cancer 0302 clinical medicine Robotic Surgical Procedures Interquartile range medicine Humans Contraindication Aged Retrospective Studies Prostatectomy business.industry Prostatic Neoplasms Middle Aged medicine.disease Surgery Lithotomy position Dissection Treatment Outcome 030220 oncology & carcinogenesis business Radical perineal prostatectomy Abdominal surgery
Zdroj:	BJU International. 125:573-578
ISSN:	1464-410X 1464-4096
Popis:	Objectives To assess the early functional and oncological outcomes of a large series of patients who underwent robot-assisted radical perineal prostatectomy (RPP). Materials and methods We retrospectively analysed the patients who underwent robot-assisted RPP for localized prostate cancer between November 2016 and September 2018. Patients who had locally advanced disease proven on biopsy or were suspected to have locally advanced disease on multiparametric magnetic resonance imaging and patients who had a contraindication for the exaggerated lithotomy position were not included in this study. Patient demographics, preoperative and postoperative variables, complications and follow-up times were recorded. Results A total of 95 patients were included. Their mean ± sd age was 61.5 ± 6.5 years. The median (interquartile range [IQR]) preoperative prostate-specific antigen level was 6.1 (3.7) ng/mL, the median (IQR) operating time was 140 (25) min, and the mean ± sd blood loss was 67.4 ± 17 mL. Pelvic lymph node dissection (PLND) was performed for 12 patients (12.6%). The median (IQR) hospital stay was 1 (1) days. Positive surgical margins were present in eight patients (8.4%). After catheter removal, the immediate continence rate was 41%. Continence rates were 78%, 87% and 91%, respectively, 3, 6 and 12 months after surgery. Potency rates were 49%, 69% and 77%, respectively, 3, 6 and 12 months after surgery for patients who had adequate potency preoperatively. The median (IQR) follow-up time was 13 (3.1) months. Conclusion We conclude that robot-assisted RPP is a reliable and effective surgical technique that can be employed in the treatment of localized prostate cancer regardless of prostate volume, especially in patients with a history of abdominal surgery. As an additional advantage, PLND can be performed through the same incision.
Databáze:	OpenAIRE
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