scholarly journals Stratified analysis of 800 Asian patients after robot-assisted radical prostatectomy with a median 64 months of follow up

2016 ◽  
Vol 23 (9) ◽  
pp. 765-774 ◽  
Author(s):  
Ali Abdel Raheem ◽  
Dae Keun Kim ◽  
Glen Denmer Santok ◽  
Ibrahim Alabdulaali ◽  
Byung Ha Chung ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Robot Assisted ◽  
Asian Patients ◽  
Stratified Analysis

scholarly journals Complications following robot-assisted radical prostatectomy in a prospective Canadian cohort of 305 consecutive cases

2013 ◽  
Vol 7 (3-4) ◽  
pp. 116-21 ◽  
Author(s):  
Andrew Fuller ◽  
Stephen E. Pautler
Keyword(s):  
Radical Prostatectomy ◽  
Major Complication ◽  
Robot Assisted ◽  
Pharmacological Management ◽  
Surgical Technology ◽  
Related Information ◽  
Open Radical Prostatectomy ◽  
Institutional Ethics ◽  
Patient Consent

Background: Robot-assisted radical prostatectomy (RARP) has emerged in the last decade as an alternative to open radical prostatectomy for men with localized prostate cancer. The increased cost of this technique has been justified by its ability to reduce blood loss, and to provide improved vision, less postoperative pain and more rapid recovery from surgery, while maintaining satisfactory oncological and functional outcomes. Given the increasing diffusion of robotic surgical technology within Canada and its associated high capital and operating costs, we review the clinical outcomes and complications from 305 consecutive cases performed at our Canadian institution.Methods: A consecutive cohort of 305 patients with a mean follow up of 30 months was analyzed with institutional ethics approval. All patients were treated and reviewed postoperatively by a single surgeon (SP). The primary aim of the study was to assess the incidence and type of complications associated with RARP in a Canadian setting. Our prospective database captured preoperative, intra-operative and postoperative data and was maintained by an individual independent of the robotic program. We report complications categorized according to the Clavien system. Multiple complications seen in an individual were recorded separately for the purposes of our analysis.Results: Between April 2005 and October 2010, 305 patients underwent RARP at our institution. A total of 70 complications were identified, with 47 (67.1%) requiring only conservative or pharmacological management (Clavien I-II). Twenty-three patients were found to have a major complication (Clavien III-V). Of the 16 who required intervention under general anesthesia, 3 required emergency treatment and the remaining patients underwent elective surgery.Conclusions: RARP has been incorporated at our institution with an acceptably low rate of intra-operative and postoperative complications. We have found that the database was effective in providing patients with outcome-related information, which in turn helped us gain patient consent with regard to the institution-specific risks of RARP.

scholarly journals Does transition from standard to Retzius-sparing technique in robot-assisted radical prostatectomy affect the functional and oncological outcomes?

2021 ◽  
Vol 93 (4) ◽  
pp. 399-403
Author(s):  
Hakan Anıl ◽  
Kaan Karamık ◽  
Ali Yıldız ◽  
Murat Savaş
Keyword(s):  
Radical Prostatectomy ◽  
Learning Curve ◽  
Surgical Margin ◽  
Nerve Sparing ◽  
Robot Assisted ◽  
Continence Status ◽  
Oncological Results ◽  
Group 2 ◽  
Group 1

Objective: To appraise the outcomes on the Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) learning curve of a surgeon with previous experience of anterior (standard) RARP. Materials and methods: The first 50 cases during the Rs-RARP learning curve (group 1) and 50 cases after the second 100 cases with the standard approach (group 2) were comprised in the study. Patients who used zero or one safety pads were considered continent. Erectile function recuperation was characterized as the competence to achieve penetrative intercourse without receiving any medication. All patients were reevaluated at two weeks, first, third, sixth, and 12th months after surgery using IIEF-5, PSA level, and continence status. Results: Immediate continence rates following catheter removal were 32/50 (64%) in Rs-RARP group and 26/50 (52%) in S-RARP group (p = 0.224). The continence recovery rate was 48/50 (96%) in Rs-RARP group and 46/50 (92%) in the S-RARP group at 12 months follow-up (p = 0.400). Total nerve-sparing surgery was enforced in 36/50 (72%) patients for group 1 and 35/50 (70%) patients for group 2. Potency recovery was 27/43 (62.8%) in Rs-RARP and 30/44 (68.2%) for S-RARP at 12 months follow up (p = 0.597). Surgical margin positivity was detected in 6/50 (12%) cases in the Rs-RARP group and in 4/50 (8%) cases in the S-RARP (p = 0.444). Conclusions: Functional and oncological results are not negatively affected in the first 50 cases for a surgeon who is experienced in S-RARP before transition to the Rs-RARP method.

scholarly journals Robot-assisted radical prostatectomy: 10-years follow-up of 60 initial patients

2021 ◽  
Vol 33 ◽  
pp. S23
Author(s):  
K. Kolontarev ◽  
V. Govorov ◽  
V. Diakov ◽  
K. Ramazanov ◽  
U. Pushkar
Keyword(s):  
Radical Prostatectomy ◽  
Robot Assisted

scholarly journals Salvage robot-assisted radical prostatectomy (sRARP) for radiation resistant prostate cancer in a group of initially high risk patients

2017 ◽  
Vol 1 (1) ◽  
pp. 21-27
Author(s):  
Nirmal Lamichhane ◽  
Adam S. Dowrick ◽  
Ulrika Axcrona ◽  
Bjørn Brennhovd ◽  
Sophie D. Fosså ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
High Frequency ◽  
Salvage Treatment ◽  
Rectal Injury ◽  
Robot Assisted ◽  
Radiation Resistant ◽  
Risk Patients

Introduction: Salvage robot-assisted radical prostatectomy (sRARP) is seen as an attractive option for salvage treatment of radiation therapy -recurrent prostate cancer (PC), thanks in part to the good visualisation that is possible using this modality. However, the results of fewer than 200 salvage sRARPs have been published in the literature. We report the outcomes in a cohort of initially high risk patients of robot-assisted radical prostatectomy as salvage local therapy for radiation-resistant PC in a Scandinavian healthcare setting. Materials and methods: A retrospective review of the charts of all patients who underwent sRARP for biochemical failure (BCF) after primary radiation treatment for localised PC at a single institution was performed. Results: Twenty-two patients, median age 67 years (range 57 to 72), had sRARP performed between June 2008 to July 2013. A median follow-up of 26 months (range 2 to 63) was observed. Perioperative complications occurred in 4 patients (18%), with one patient sustaining a rectal injury. Histo-pathological diagnosis was pT2 in three, pT3a in five, pT3b in twelve and pTx in one patient. Ten patients (45%) had a positive surgical margin (PSM). At follow-up, 54 % of patients were free of biochemical progression and 41% were continent. Conclusions: We showed that salvage RARP is technically feasible in a cohourt of patients with predominantly high risk disease. This study adds to the limited data already in the literature, demonstrating the high frequency of locally advanced (pT3b) PC, a patient group that is usually not included in salvage treatments, as e.g. high frequency ultrasound or salvage brachytherapy. Further, given that the historical barriers to salvage RP with higher rates of rectal injury and poor urinary control no longer seem to be applicable in the modern era, we think that more patients should be considered candidates for this potentially curative salvage treatment of radiation-resistant PC. However, long-term follow-up is needed to confirm if the additional burden on these patients confers to oncological control following the procedure.

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