Your browser doesn't support javascript.
loading
Retzius-sparing robot-assisted laparoscopic radical prostatectomy: functional and early oncologic results in aggressive and locally advanced prostate cancer.
Nyarangi-Dix, Joanne Nyaboe; Görtz, Magdalena; Gradinarov, Georgi; Hofer, Luisa; Schütz, Viktoria; Gasch, Claudia; Radtke, Jan Philipp; Hohenfellner, Markus.
Afiliação
  • Nyarangi-Dix JN; Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
  • Görtz M; Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany. magdalena.goertz@med.uni-heidelberg.de.
  • Gradinarov G; Ruprecht-Karls University of Heidelberg, Medical Faculty, Heidelberg, Germany.
  • Hofer L; Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
  • Schütz V; Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
  • Gasch C; Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
  • Radtke JP; Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
  • Hohenfellner M; Department of Urology, University Hospital Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.
BMC Urol ; 19(1): 113, 2019 Nov 12.
Article em En | MEDLINE | ID: mdl-31718600
ABSTRACT

BACKGROUND:

Retzius-sparing robot-assisted laparoscopic radical prostatectomy (rsRARP) allows entire prostatectomy procedure via the pouch of Douglas. In low- and intermediate-risk prostate cancer (PCa) there is level 1 evidence that the Retzius-sparing approach impacts early continence recovery. Since specific data on aggressive and locally advanced cancer is lacking and avoiding rsRARP is presently suggested, we investigated urinary and sexual recovery, perioperative complications and early oncologic outcomes after rsRARP in this particular cohort.

METHODS:

Prospectively collected data of 50 consecutive men (median age 66 years) with high-risk PCa who underwent rsRARP in a single institution was analysed retrospectively. The follow-up for all patients was 12 months after surgery.

RESULTS:

3 vs. 12 months after surgery, 82% vs. 98% of men used no pad or one safety pad and 50% vs. 72% used no pad. 89% of patients did not observe a decline of continence if postoperative radiotherapy was carried out. Considering the 17 preoperatively potent patients who underwent bi- or unilateral nerve-sparing surgery, 41% reported their first sexual intercourse within 1 year after rsRARP. 84% of patients had ≥pT3a disease and 42% positive surgical margins. A lymphadenectomy was done in 94% of patients with a median lymph node removal of 15 and lymph node metastasis in 13%. 34% underwent adjuvant radiotherapy and 22% adjuvant androgen deprivation therapy (ADT). 1-year recurrence-free survival was 96%, including 25% of patients on adjuvant or salvage ADT.

CONCLUSIONS:

RsRARP in high-risk PCa is feasible and results in excellent continence rates, even after postoperative radiotherapy. The potency rates are promising but need further clarification in larger cohorts. Reliable oncologic outcomes require longterm follow-up and are awaited.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Procedimentos Cirúrgicos Robóticos Tipo de estudo: Observational_studies Limite: Aged / Humans / Male Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata / Procedimentos Cirúrgicos Robóticos Tipo de estudo: Observational_studies Limite: Aged / Humans / Male Idioma: En Ano de publicação: 2019 Tipo de documento: Article