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.
| Original language | English |
|---|---|
| Pages (from-to) | 135-141 |
| Number of pages | 7 |
| Journal | BJU International |
| Volume | 119 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2017 Jan 1 |
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All Science Journal Classification (ASJC) codes
- Urology
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Perioperative and short-term outcomes of Retzius-sparing robot-assisted laparoscopic radical prostatectomy stratified by gland size. / 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.
In: BJU International, Vol. 119, No. 1, 01.01.2017, p. 135-141.Research output: Contribution to journal › Article
TY - JOUR
T1 - Perioperative and short-term outcomes of Retzius-sparing robot-assisted laparoscopic radical prostatectomy stratified by gland size
AU - Santok, Glen D.R.
AU - Abdel Raheem, Ali
AU - Kim, Lawrence H.C.
AU - Chang, Kidon
AU - Lum, Trenton G.H.
AU - Chung, Byung H.
AU - Choi, Young D.
AU - Rha, Koon H.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84992663832&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84992663832&partnerID=8YFLogxK
U2 - 10.1111/bju.13632
DO - 10.1111/bju.13632
M3 - Article
C2 - 27539553
AN - SCOPUS:84992663832
VL - 119
SP - 135
EP - 141
JO - BJU International
JF - BJU International
SN - 1464-4096
IS - 1
ER -