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- Title
Retzius-sparing robot-assisted laparoscopic radical prostatectomy: combining the best of retropubic and perineal approaches.
- Authors
Lim, Sey Kiat; Kim, Kwang Hyun; Shin, Tae‐Young; Han, Woong Kyu; Chung, Byung Ha; Hong, Sung Joon; Choi, Young Deuk; Rha, Koon Ho
- Abstract
Objective To compare the early peri-operative, oncological and continence outcomes of Retzius-sparing robot-assisted laparoscopic radical prostatectomy ( RALP) with those of conventional RALP. Materials and Methods Data from 50 patients who underwent Retzius-sparing RALP and who had at least 6 months of follow-up were prospectively collected and compared with a database of patients who underwent conventional RALP. Propensity-score matching was performed using seven preoperative variables, and postoperative variables were compared between the groups. Results A total of 581 patients who had undergone RALP were evaluated in the present study. Although preoperative characteristics were different before propensity-score matching, these differences were resolved after matching. There were no significant differences in mean length of hospital stay, estimated blood loss, intra- and postoperative complication rates, pathological stage of disease, Gleason scores, tumour volumes and positive surgical margins between the conventional RALP and Retzius-sparing RALP groups. Console time was shorter for Retzius-sparing RALP. Recovery of early continence (defined as 0 pads used) at 4 weeks after RALP was significantly better in the Retzius-sparing RALP group than in the conventional RALP group. Conclusions The present results suggest that Retzius-sparing RALP, although technically more demanding, was as feasible and effective as conventional RALP, and also led to a shorter operating time and faster recovery of early continence. Retzius-sparing RALP was also reproducible and achievable in all cases.
- Subjects
PROSTATECTOMY; PROSTATE surgery; MEDICAL databases; URINARY incontinence; TUMORS
- Publication
BJU International, 2014, Vol 114, Issue 2, p236
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/bju.12705