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Stefanie von Mechow, Markus Graefen, Alexander Haese, Pierre Tennstedt, Dirk Pehrke, Frank Friedersdorff, Burkhard Beyer
PURPOSE: To compare the duration of sick leave in patients with localized prostate cancer after robot-assisted radical prostatectomy (RARP) and open retropubic RP (ORP) at a German high-volume prostate cancer center. METHODS: The data of 1,415 patients treated with RP at Martini Klinik, Prostate Cancer Center between 2012 and 2016 were, retrospectively, analyzed. Information on employment status, monthly revenues and days of work missed due to sickness were assessed via online questionnaire...
March 15, 2018: Urologic Oncology
Giorgio Gandaglia, Carlo Andrea Bravi, Paolo Dell'Oglio, Elio Mazzone, Nicola Fossati, Simone Scuderi, Daniele Robesti, Francesco Barletta, Luca Grillo, Steven Maclennan, James N'Dow, Francesco Montorsi, Alberto Briganti
The rate of postoperative complications might vary according to the method used to collect perioperative data. We aimed at assessing the impact of the prospective implementation of the European Association of Urology (EAU) guidelines on reporting and grading of complications in prostate cancer patients undergoing robot-assisted radical prostatectomy (RARP). From September 2016, an integrated method for reporting surgical morbidity based on the EAU guidelines was implemented at a single, tertiary center. Perioperative data were prospectively and systematically collected during a patient interview at 30 d after surgery as recommended by the EAU Guidelines Panel Recommendations on Reporting and Grading Complications...
March 12, 2018: European Urology
Wataru Jomoto, Masao Tanooka, Hiroshi Doi, Keisuke Kikuchi, Chiemi Mitsuie, Yusuke Yamada, Toru Suzuki, Toshiko Yamano, Reiichi Ishikura, Noriko Kotoura, Shingo Yamamoto
We sought to develop a surgical navigation system using magnetic resonance angiography (MRA) and a three-dimensional (3D) printer for robot-assisted radical prostatectomy (RARP). Six patients with pathologically proven localized prostate cancer were prospectively enrolled in this study. Prostate magnetic resonance imaging (MRI), consisting of T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) and true fast imaging with steady-state precession (true FISP), reconstructed by volume rendering, was followed by dynamic contrast-enhanced MRA performed with a volumetric interpolated breath-hold examination (VIBE) during intravenous bolus injection of gadobutrol...
January 2, 2018: Curēus
Linda M Huynh, Kathryn Osann, Douglas Skarecky, Thomas E Ahlering
OBJECTIVE: To introduce a patient-reported erection fullness scale (% fullness) following robot-assisted radical prostatectomy as a qualitative adjunct to the IIEF-5 and as a 90-day predictor of two-year potency outcomes. PATIENTS AND METHODS: Prospective data was collected from 540 men with preoperative IIEF-5 22-25 who underwent RARP by a single surgeon, of which 299 had complete data at all time points up to 2 years. In addition to standard assessment tools (IIEF-5 and erections sufficient for intercourse), patients were asked to "indicate the fullness you are able to achieve in erections compared to before surgery?" (0-10…100%)...
March 9, 2018: BJU International
P Chandak, N Byrne, H Lynch, C Allen, G Rottenberg, A Chandra, N Raison, H Ahmed, V Kasivisvanathan, O Elhage, P Dasgupta
The surgical management of prostate cancer has been shown to be determined by the anatomical location of the tumour and its associated intricate relationship to the neurovascular bundle and the prostatic capsule. Studies have shown an improvement in decision making about preservation or resection of neurovascular bundles during robotic assisted prostatectomy (RARP) [1,2] during which the surgeon lacks the tactile feedback of conventional open surgery. This article is protected by copyright. All rights reserved...
March 6, 2018: BJU International
A Jaulim, A Srinivasan, S Hori, N Kumar, A Y Warren, N C Shah, V J Gnanapragasam
Introduction The aim of this study was to explore the impact of increasing proportions of high risk referrals on surgical margin outcomes of a surgeon's learning curve in robotic prostatectomy. Methods All patients in this study underwent robot assisted radical prostatectomy (RARP) performed by three different consultant urological surgeons. Data collected included preoperative clinical stage, Gleason score and prostate specific antigen levels, which were used to risk stratify patients according to National Institute for Health and Care Excellence criteria...
March 2018: Annals of the Royal College of Surgeons of England
Lorenzo Giuseppe Luciani, Daniele Mattevi, William Mantovani, Tommaso Cai, Stefano Chiodini, Valentino Vattovani, Marco Puglisi, Daniele Tiscione, Umberto Anceschi, Gianni Malossini
Background: To compare the surgical outcomes of radical prostatectomy (RP) performed via 3 different approaches: retropubic (RRP), laparoscopic-assisted (LRP), and robot-assisted (RARP), in a single non-academic regional center by a single surgeon. Materials and Methods: The data of patients undergoing RP from 2005 to 2014 were reviewed. The standard approach changed through the years: RRP (n = 380, years 2005 to 2008), LRP (n = 240, years 2009 to 2011), and RARP (n = 262, years 2012 to 2014)...
November 2017: Current Urology
Andrew Hung, Jian Chen, Zhengping Che, Tanachat Nilanon, Anthony Jarc, Micha Titus, Paul Oh, Inderbir Singh Gill, Yan Liu
Purpose Surgical performance is critical for clinical outcomes. We present a novel machine learning (ML) method of processing automated performance metrics (APMs) to evaluate surgical performance and predict clinical outcomes after robot-assisted radical prostatectomy (RARP). Methods We trained three ML algorithms utilizing APMs directly from robot system data (training material) and hospital length of stay (LOS; training label) (≤2 days and >2days) from 78 RARP cases, and selected the algorithm with the best performance...
February 16, 2018: Journal of Endourology
Muammer Altok, Kara Babaian, Mary F Achim, Grace C Achim, Patricia Troncoso, Surena F Matin, Brian F Chapin, John W Davis
OBJECTIVES: To evaluate the peri-operative, pathologic, and oncologic outcomes from surgeon led pathologic staging of pelvic lymph node metastases at the time of robot-assisted radical prostatectomy (RARP). PATIENTS AND METHODS: Over the 6-year period of 2006-2012, three distinct pelvic lymph node dissection strategies were utilized in chronologic order at a single cancer referral hospital. Strategies were characterized by both a 1) omission of PLND versus inclusion decision threshold, and 2) standard versus extended templates for patients selected for PLND...
February 15, 2018: BJU International
Angelika Borkowetz, Johannes Bruendl, Martin Drerup, Jonas Herrmann, Hendrik Isbarn, Burkhard Beyer
PURPOSE: Pelvic lymph node dissection (PLND) is recommended for patients with prostate cancer (PCa) and significant risk for nodal metastases. This study aimed to assess guideline adherence regarding PLND according to the German S3 guideline as example for a national but highly used guideline on prostate cancer and to compare the rate of complications different approaches for radical prostatectomy (RP). METHODS: Patients undergoing open (RRP), laparoscopic (LARP) or robot-assisted (RARP) RP in six centers in Germany and Austria were included...
February 9, 2018: World Journal of Urology
Lorenzo Bianchi, Filippo Maria Turri, Alessandro Larcher, Ruben De Groote, Peter De Bruyne, Vincent De Coninck, Marijn Goossens, Frederiek D'Hondt, Geert De Naeyer, Peter Schatteman, Alexandre Mottrie
BACKGROUND: Apical dissection in robot-assisted radical prostatectomy (RARP) affects not only cancer control, but also continence recovery. OBJECTIVE: To describe a novel approach for apical dissection, the collar technique, to reduce apical positive surgical margins (PSMs). DESIGN, SETTING, AND PARTICIPANTS: A total of 189 consecutive patients (81 in the control group, 108 in the collar technique group) underwent RARP at a single center. PRIMARY OUTCOME: rates of apical PSMs; secondary outcome: urinary continence...
February 2, 2018: European Urology Focus
Khaled Ajib, Marc Zanaty, Mansour Alnazari, Emad Rajih, Pierre-Alain Hueber, Mila Mansour, Roger Valdivieso, Cristina Negrean, Pierre I Karakiewicz, Daniel Taussky, Guila Delouya, Assaad El-Hakim, Kevin C Zorn
INTRODUCTION: We sought to determine the impact of salvage radiotherapy (SRT) on oncological and functional outcomes of patients with prostate cancer after biochemical recurrence (BCR) following robot-assisted radical prostatectomy (RARP). METHODS: Data of 70 patients with prostate cancer treated with SRT after developing BCR were retrospectively analyzed from a prospectively collected RARP database of 740 men. Oncological (PSA) and functional (pads/day, International Prostate Symptom Score [IPSS], and Sexual Health Inventory for Men [SHIM]) outcomes were reported at six, 12, and 24 months after RT and adjusted for pre-SRT status...
December 1, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Angelo Porreca, Daniele D'Agostino, Matteo Dandrea, Antonio Salvaggio, Alessandro Del Rosso, Emanuele Cappa, Alessio Zuccalà, Daniele Romagnoli, Riccardo Schiavina
BACKGROUND: The aim of the work is to describe an original technique of posterior muscle-fascial reconstruction (PMFR) during Robot-assisted radical prostatectomy (RARP). METHODS: From January 2015 to June 2016, 121 consecutives patients underwent RARP and were submitted to a novel tecnique of PMFR, using a single 3/0 barbed bi-directional (Filblock ® - Assut Europe) suture. The first step of this new technique of PMFR, is to approximate the posterior layer of Denonvilliers fascia (DF) to the posterior part of the sphinteric apparatus...
January 29, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Tetsuya Yumioka, Masashi Honda, Yusuke Kimura, Noriya Yamaguchi, Hideto Iwamoto, Shuichi Morizane, Katsuya Hikita, Atsushi Takenaka
Purpose: To evaluate in Japanese patients their sexual function after robot-assisted radical prostatectomy (RARP) and to investigate the influence of the multinerve-sparing (NS) grade on their sexual function. Methods: In total, 225 patients were reviewed with localized prostate cancer who underwent RARP at the authors' institution. They underwent RARP >3 months ago, without pre- and posthormone therapy and salvage radiation. Self-administered International Index of Erectile Function (IIEF) questionnaires were used for assessment preoperatively and 1-48 months postoperatively...
January 2018: Reproductive Medicine and Biology
Ho Won Kang, Hae Do Jung, Joo Yong Lee, Jong Kyou Kwon, Seong Uk Jeh, Kang Su Cho, Won Sik Ham, Young Deuk Choi
BACKGROUND: Significant clinical heterogeneity within contemporary risk group is well known, particularly for those with intermediate-risk prostate cancer (IRPCa). Our study aimed to analyze the ability of the Cancer of the Prostate Risk Assessment (CAPRA) score to discern between favorable and non-favorable risk in patients with IRPCa. METHODS: We retrospectively reviewed the data of 203 IRPCa patients who underwent extraperitoneal robot-assisted radical prostatectomy (RARP) performed by a single surgeon...
January 29, 2018: Journal of Korean Medical Science
Julie Nossiter, Arunan Sujenthiran, Susan C Charman, Paul J Cathcart, Ajay Aggarwal, Heather Payne, Noel W Clarke, Jan van der Meulen
BACKGROUND: Robot-assisted radical prostatectomy (RARP) has been rapidly adopted without robust evidence comparing its functional outcomes against laparoscopic radical prostatectomy (LRP) or open retropubic radical prostatectomy (ORP) approaches. This study compared patient-reported functional outcomes following RARP, LRP or ORP. METHODS: All men diagnosed with prostate cancer in England during April - October 2014 who underwent radical prostatectomy were identified from the National Prostate Cancer Audit and mailed a questionnaire 18 months after diagnosis...
January 18, 2018: British Journal of Cancer
Ja Yoon Ku, Chan Ho Lee, Won Young Park, Nam Kyung Lee, Seung Hyun Baek, Hong Koo Ha
BACKGROUND: The aim of this study is to investigate the cumulative incidence and risk factors of postoperative inguinal hernia (PIH) in patients undergoing radical prostatectomy, i.e., laparoscopic prostatectomy (LRP) and robot-assisted laparoscopic prostatectomy (RARP). METHODS: This study included 1124 patients who had undergone radical prostatectomy or transurethral resection of bladder tumor from 2011-2016. We compared the cumulative incidence of PIH in the radical prostatectomy groups (460; LRP 341, RARP 119) and the control group (664; transurethral resection of bladder tumor), and we then analyzed the risk factors (age, operative methods, previous abdominal operative history, thickness and width of external oblique muscle and rectus muscle, thickness of abdominal subcutaneous fat layer at Hesselbach's triangle level, body mass index, prostate-specific antigen, operative time, specimen weight, Gleason score, and pathology T-stage) of PIH in the radical prostatectomy groups...
January 16, 2018: International Journal of Clinical Oncology
Yuefeng Du, Qingzhi Long, Bin Guan, Lijun Mu, Juanhua Tian, Yumei Jiang, Xiaojing Bai, Dapeng Wu
BACKGROUND Robot-assisted radical prostatectomy (RARP) is increasingly used worldwide, but comparisons of perioperative, functional, and oncologic outcomes among RARP, laparoscopic radical prostatectomy (LRP), and open radical prostatectomy (ORP) remain inconsistent. MATERIAL AND METHODS Systematic literature searches were conducted using EMBASE, PubMed, the Cochrane Library, CNKI, and Science Direct/Elsevier up to April 2017. A meta-analysis was conducted using Review Manager and Stata software. RESULTS We included 33 studies...
January 14, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Zhongyu Jian, Shijian Feng, Yuntian Chen, Xin Wei, Deyi Luo, Hong Li, Kunjie Wang
BACKGROUND: Prostate cancer is one of the most common cancers in the elderly population. The standard treatment is radical prostatectomy (RARP). However, urologists do not have consents on the postoperative urine drainage management (suprapubic tube (ST)/ urethral catheter (UC)). Thus, we try to compare ST drainage to UC drainage after robot-assisted radical prostatectomy regarding to comfort, recovery rate and continence using the method of meta-analysis. METHODS: A systematic search was performed in Dec...
January 5, 2018: BMC Urology
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