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

Authors
 Sey Kiat Lim  ;  Kwang Hyun Kim  ;  Tae-Young Shin  ;  Woong Kyu Han  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Young Deuk Choi  ;  Koon Ho Rha 
Citation
 BJU INTERNATIONAL, Vol.114(2) : 236-244, 2014 
Journal Title
 BJU INTERNATIONAL 
ISSN
 1464-4096 
Issue Date
2014
MeSH
Aged ; Cohort Studies ; Feasibility Studies ; Humans ; Laparoscopy/methods* ; Male ; Middle Aged ; Operative Time ; Organ Sparing Treatments ; Perineum/surgery ; Prostate/innervation ; Prostatectomy/methods* ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery* ; Recovery of Function ; Reproducibility of Results ; Robotics* ; Treatment Outcome ; Urinary Bladder/surgery
Keywords
continence ; nerve-sparing ; perineal ; prostate cancer ; prostatectomy
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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/bju.12705/abstract
DOI
10.1111/bju.12705
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Hyun(김광현)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Shin, Tae Young(신태영)
Lim, Sey Kiat(임세이캣)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99678
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