Does previous transurethral resection of the prostate affect the outcomes in robotic assisted radical prostatectomy?
Prostate cancer
Radical prostatectomy
Robotic-assisted
Transurethral resection of the prostate
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
22 Jun 2024
22 Jun 2024
Historique:
received:
11
02
2024
accepted:
01
06
2024
medline:
23
6
2024
pubmed:
23
6
2024
entrez:
22
6
2024
Statut:
epublish
Résumé
Transurethral resection of the prostate (TURP) is one of the surgical options for treating enlarged prostates with lower urinary symptoms (LUTS). In this older group of patients, concomitant prostate cancer is not uncommon. However, the fibrosis and distortion of the prostate anatomy by prior TURP can potentially hinder surgical efficacy at robotic-assisted radical prostatectomy (RARP). We aim to evaluate functional, and oncologic outcomes of RARP in patients with and without previous TURP. 231 men with previous TURP underwent RARP (TURP group). These men were propensity score matched using clinicopathological characteristics to men without previous TURP who underwent RARP (Control group). Perioperative and postoperative variables were analysed for significant differences in outcomes between groups. Variables analysed included estimated blood loss (EBL), operative time, catheter time, hospitalization time, postoperative complications, positive surgical margins (PSM) rates, cancer status, biochemical recurrence (BCR), potency, and continence rates. Patients in the TURP group showed no statistically significant differences in operative safety measures including median EBL, operative time, catheter time, hospitalization time or postoperative complications. No significant difference between the groups in terms of potency rates and continence rates. Furthermore, there were no statistically significant differences in oncological outcomes, including PSM rates (15% vs 18%, P = 0.3) and BCR. In RARP after TURP there is often noticeable distortion of the surgical anatomy. For an experienced team the procedure is safe and provides similar oncologic control and functional outcomes to RARP in patients without previous TURP.
Identifiants
pubmed: 38909142
doi: 10.1007/s00345-024-05105-y
pii: 10.1007/s00345-024-05105-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
384Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Gupta NP, Singh P, Nayyar R (2011) Outcomes of robot-assisted radical prostatectomy in men with previous transurethral resection of prostate. BJU Int 108:1501–1505. https://doi.org/10.1111/j.1464-410X.2011.10113.x
doi: 10.1111/j.1464-410X.2011.10113.x
pubmed: 21392223
Garg H, Seth A, Kumar R (2022) Impact of previous transurethral resection of prostate on robot-assisted radical prostatectomy: a matched cohort analysis. J Robot Surg 16:1123–1131. https://doi.org/10.1007/s11701-021-01348-8
doi: 10.1007/s11701-021-01348-8
pubmed: 34978049
Su Y-K, Katz BF, Sehgal SS et al (2015) Does previous transurethral prostate surgery affect oncologic and continence outcomes after RARP? J Robot Surg 9:291–297. https://doi.org/10.1007/s11701-015-0529-9
doi: 10.1007/s11701-015-0529-9
pubmed: 26530840
Hampton L, Nelson RA, Satterthwaite R et al (2008) Patients with prior TURP undergoing robot-assisted laparoscopic radical prostatectomy have higher positive surgical margin rates. J Robot Surg 2:213–216. https://doi.org/10.1007/s11701-008-0121-7
doi: 10.1007/s11701-008-0121-7
pubmed: 27637789
Zugor V, Labanaris AP, Porres D, Witt JH (2012) Surgical, oncologic, and short-term functional outcomes in patients undergoing robot-assisted prostatectomy after previous transurethral resection of the prostate. J Endourol 26:515–519. https://doi.org/10.1089/end.2011.0205
doi: 10.1089/end.2011.0205
pubmed: 21913854
Moschovas MC, Patel V (2022) Nerve-sparing robotic-assisted radical prostatectomy: how I do it after 15.000 cases. Int Braz J Urol 48:369–370. https://doi.org/10.1590/s1677-5538.ibju.2022.99.03
doi: 10.1590/s1677-5538.ibju.2022.99.03
pubmed: 34786924
Bhat KRS, Moschovas MC, Onol FF et al (2021) Evidence-based evolution of our robot-assisted laparoscopic prostatectomy (RALP) technique through 13,000 cases. J Robot Surg 15:651–660. https://doi.org/10.1007/s11701-020-01157-5
doi: 10.1007/s11701-020-01157-5
pubmed: 33040249
Covas Moschovas M, Bhat S, Onol FF et al (2020) Modified apical dissection and lateral prostatic fascia preservation improves early postoperative functional recovery in robotic-assisted laparoscopic radical prostatectomy: results from a propensity score–matched analysis. Eur Urol 78:875–884. https://doi.org/10.1016/j.eururo.2020.05.041
doi: 10.1016/j.eururo.2020.05.041
pubmed: 32593529
Seetharam Bhat KR, Moschovas MC, Sandri M et al (2021) Stratification of potency outcomes following robot-assisted laparoscopic radical prostatectomy based on age, preoperative potency, and nerve sparing. J Endourol 35:1631–1638. https://doi.org/10.1089/end.2021.0141
doi: 10.1089/end.2021.0141
pubmed: 33947270
Colombo R, Naspro R, Salonia A et al (2006) Radical prostatectomy after previous prostate surgery: clinical and functional outcomes. J Urol 176:2459–2463. https://doi.org/10.1016/j.juro.2006.07.140
doi: 10.1016/j.juro.2006.07.140
pubmed: 17085129
Martini A, Falagario UG, Villers A et al (2020) Contemporary techniques of prostate dissection for robot-assisted prostatectomy. Eur Urol 78:583–591. https://doi.org/10.1016/j.eururo.2020.07.017
doi: 10.1016/j.eururo.2020.07.017
pubmed: 32747200
Basourakos SP, Kowalczyk K, Moschovas MC et al (2021) Robot-assisted radical prostatectomy maneuvers to attenuate erectile dysfunction: technical description and video compilation. J Endourol 35:1601–1609. https://doi.org/10.1089/end.2021.0081
doi: 10.1089/end.2021.0081
pubmed: 34015959
Moschovas MC, Menon M, Noël J, Patel V (2022) Techniques and potency outcomes for nerve-sparing RARP. In: Wiklund P, Mottrie A, Gundeti MS, Patel V (eds) Robotic urologic surgery. Springer International Publishing, Cham, pp 165–170
doi: 10.1007/978-3-031-00363-9_15
Martin AD, Desai PJ, Nunez RN et al (2009) Does a history of previous surgery or radiation to the prostate affect outcomes of robot-assisted radical prostatectomy? BJU Int 103:1696–1698. https://doi.org/10.1111/j.1464-410X.2008.08276.x
doi: 10.1111/j.1464-410X.2008.08276.x
pubmed: 19154449
Hung C-F, Yang C-K, Ou Y-C (2014) Robotic assisted laparoscopic radical prostatectomy following transurethral resection of the prostate: perioperative oncologic and functional outcomes. Prostate Int. 2:82–89. https://doi.org/10.12954/PI.14046
doi: 10.12954/PI.14046
pubmed: 25032194
pmcid: 4099399
Tappero S, Vecchio E, Palagonia E et al (2023) Retzius-sparing robot-assisted radical prostatectomy after previous trans-urethral resection of the prostate: Assessment of functional and oncological outcomes. Eur J Surg Oncol. https://doi.org/10.1016/j.ejso.2023.03.218
doi: 10.1016/j.ejso.2023.03.218
pubmed: 37012110
Tugcu V, Atar A, Sahin S et al (2015) Robot-assisted radical prostatectomy after previous prostate surgery. JSLS 19(e2015):00080. https://doi.org/10.4293/JSLS.2015.00080
doi: 10.4293/JSLS.2015.00080
Liao H, Duan X, Du Y et al (2020) Radical prostatectomy after previous transurethral resection of the prostate: oncological, surgical and functional outcomes-a meta-analysis. World J Urol 38:1919–1932. https://doi.org/10.1007/s00345-019-02986-2
doi: 10.1007/s00345-019-02986-2
pubmed: 31679064
Creta M, Manfredi C, Arcaniolo D et al (2023) Functional and oncological outcomes after radical prostatectomy in patients with history of surgery for lower urinary tract symptoms related to benign prostatic enlargement: a systematic review with meta-analysis. Prostate Cancer Prostatic Dis. https://doi.org/10.1038/s41391-023-00678-y
doi: 10.1038/s41391-023-00678-y
pubmed: 37244971
pmcid: 9874176
Bhat KRS, Covas Moschovas M, Sandri M et al (2021) A predictive preoperative and postoperative nomogram for postoperative potency recovery after robot-assisted radical prostatectomy. J Urol 206:942–951. https://doi.org/10.1097/JU.0000000000001895
doi: 10.1097/JU.0000000000001895
pubmed: 34033495
Anceschi U, Galfano A, Luciani L et al (2022) Analysis of predictors of early trifecta achievement after robot-assisted radical prostatectomy for trainers and expert surgeons: the learning curve never ends. Minerva Urol Nephrol. https://doi.org/10.23736/S2724-6051.22.04805-4
doi: 10.23736/S2724-6051.22.04805-4
pubmed: 35345386
Anceschi U, Morelli M, Flammia RS et al (2023) Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high- -volume institutions: results from a multicentric series. Cent Eur J Urol 76:38–43. https://doi.org/10.5173/ceju.2023.260
doi: 10.5173/ceju.2023.260