We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Perioperative and short-term outcomes of Retzius-sparing robot-assisted laparoscopic radical prostatectomy stratified by gland size.
- Authors
Santok, Glen D.R; Abdel Raheem, Ali; Kim, Lawrence H. C.; Chang, Kidon; Lum, Trenton G. H.; Chung, Byung H.; Choi, Young D.; Rha, Koon H.
- Abstract
Objective To investigate the effect of preoperative prostate volume ( PV) on the perioperative, continence and early oncological outcomes among patients treated with Retzius-sparing robot-assisted laparoscopic radical prostatectomy ( RS- RALP). Patients and Methods This is a retrospective analysis of 294 patients with organ-confined prostate cancer treated with RS- RALP in a high-volume centre from November 2012 to February 2015. Patients were divided into three groups based on their transrectal ultrasonography estimated PV as follows: group 1, <40 mL (231 patients); group 2, 40-60 mL (47); group 3, >60 mL (16). Perioperative, oncological, and continence outcomes were compared between the three groups. Results The median [interquartile range ( IQR)] PV for each group was; 26.1 (22-31) mL, 45.9 (41-50) mL, and 70 (68-85) mL. Blood loss was higher in group 3 compared to groups 2 and 1; at a median ( IQR) of 475 (312-575) mL, 200 (150-400) mL, and 250 (150-400) mL, respectively ( P = 0.001). The intraoperative transfusion rate was higher in group 3 patients ( P = 0.004), while the complication rate did not differ ( P = 0.05). The console time was slightly higher but was not statistically significant in group 3 compared to groups 2 and 1; at a mean ( sd) of 100 (35) min, 92 (34.4) min, and 93 (24.8) min, respectively ( P = 0.70). Biochemical recurrence and the continence rate did not differ between the three groups ( P = 0.89 and P = 0.25, respectively). Conclusion RS- RALP is oncologically and functionally equivalent for all prostate sizes but technically demanding for larger prostates. We therefore recommend that surgeons initiate their RS- RALP technique with smaller prostates.
- Subjects
CHRONOLOGY; SURGEONS; BLOOD diseases; HEMATOLOGY; CARDIOVASCULAR system
- Publication
BJU International, 2017, Vol 119, Issue 1, p135
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/bju.13632