The pubovesical complex-sparing technique on laparoscopic radical prostatectomy
| Autor: | Rafael Batista Rebouças, Rodrigo Campos Monteiro, João Paulo Pereira Lima, Filipe de Pádua B. F. Almeida, Cesar Araujo Britto, Marcos Tobias Machado, Carlo Passerotti |
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| Jazyk: | angličtina |
| Předmět: | |
| Zdroj: | International Brazilian Journal of Urology, Vol 44, Iss 4, Pp 844-845 |
| Druh dokumentu: | article |
| ISSN: | 1677-6119 1677-5538 |
| DOI: | 10.1590/s1677-5538.ibju.2017.0359 |
| Popis: | ABSTRACT Introduction: Preservation of urinary continence is a great challenge in Radical Prostatectomy. In order to improve functional results, Asimakopoulos et al. (2010) described a robot-assisted surgical technique with preservation of the pubovesical complex (PVC). We present a pure laparoscopic execution. Presentation: A 61-year-old male patient with a diagnosis of prostate cancer, with PSA 6.54ng/ml, DRE: T1C and Gleason 6 (3+3) 1/12 fragments. All therapeutic possibilities were discussed, including active surveillance. The patient opted for surgical treatment. A transperitoneal technique was used. We started the dissection on the left side, in the limit between the detrusor and the base of the prostate. The left seminal vesicle was dissected and left neurovascular bundle released by a high anterior dissection. We repeated the same procedure on the right side. The urethra was then divided, prostatic apex was laterally drawn and PVC was released. The bladder neck was divided and an urethrovesical anastomosis was achieved. A pelvic drain was placed. Results: The total operative time was 150 minutes. The estimated blood loss was 300mL. The drain was removed on the 1st postoperative day and the patient was discharged. The Foley catheter was removed after 7 days and the patient remained completely dry. Hystopathology revealed adenocarcinoma Gleason 6, negative margins. PSA after 30 days was |
| Databáze: | Directory of Open Access Journals |
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