Retzius-sparing robot-assisted laparoscopic radical prostatectomy: Combining the best of retropubic and perineal approaches

Sey Kiat Lim, Kwang Hyun Kim, Tae Young Shin, Woong Kyu Han, Byung Ha Chung, Sung Joon Hong, Young Deuk Choi, Koon Ho Rha

Research output: Contribution to journalArticle

38 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)236-244
Number of pages9
JournalBJU International
Volume114
Issue number2
DOIs
Publication statusPublished - 2014 Aug

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Prostatectomy
Propensity Score
Length of Stay
Neoplasm Grading
Intraoperative Complications
Tumor Burden

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

@article{b3c925cf70f54a9ea26a1c5dc1cbb9ba,
title = "Retzius-sparing robot-assisted laparoscopic radical prostatectomy: Combining the best of retropubic and perineal approaches",
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.",
author = "Lim, {Sey Kiat} and Kim, {Kwang Hyun} and Shin, {Tae Young} and Han, {Woong Kyu} and Chung, {Byung Ha} and Hong, {Sung Joon} and Choi, {Young Deuk} and Rha, {Koon Ho}",
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Retzius-sparing robot-assisted laparoscopic radical prostatectomy : Combining the best of retropubic and perineal approaches. / Lim, Sey Kiat; Kim, Kwang Hyun; Shin, Tae Young; Han, Woong Kyu; Chung, Byung Ha; Hong, Sung Joon; Choi, Young Deuk; Rha, Koon Ho.

In: BJU International, Vol. 114, No. 2, 08.2014, p. 236-244.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Retzius-sparing robot-assisted laparoscopic radical prostatectomy

T2 - Combining the best of retropubic and perineal approaches

AU - Lim, Sey Kiat

AU - Kim, Kwang Hyun

AU - Shin, Tae Young

AU - Han, Woong Kyu

AU - Chung, Byung Ha

AU - Hong, Sung Joon

AU - Choi, Young Deuk

AU - Rha, Koon Ho

PY - 2014/8

Y1 - 2014/8

N2 - 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.

AB - 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.

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