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Min Hur, Seokha Yoo, Jung-Yoon Choi, Sun-Kyung Park, Dhong Eun Jung, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: Dynamic change in central venous pressure (CVP) was associated with fluid responsiveness. External jugular venous pressure (EJVP) may reliably estimate CVP and have the advantages of being less invasive. We investigated whether increase in EJVP induced by positive end-expiratory pressure (PEEP) could be a reliable predictor of fluid responsiveness in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). METHODS: Fifty patients who underwent RALP with steep Trendelenburg position were enrolled...
February 27, 2018: Journal of Anesthesia
In-Jung Jun, Myong Kim, Joonho Lee, Se-Ung Park, Jai-Hyun Hwang, Jun Hyuk Hong, Young-Kug Kim
INTRODUCTION: Carbon dioxide pneumoperitoneum and the steep Trendelenburg position during robot-assisted laparoscopic prostatectomy (RALP) can increase the intracranial pressure (ICP). Mannitol is widely used to treat increased ICP. However, no studies to date have specifically evaluated the effect of mannitol on ICP in patients undergoing RALP. Ultrasonographic measurement of the optic nerve sheath diameter (ONSD) is considered a reliable technique to noninvasively evaluate the ICP. Therefore, this study compared ONSDs as a surrogate for ICP before and after mannitol administration in prostate cancer patients undergoing RALP...
February 7, 2018: Journal of Endourology
Sinan Khadhouri, Catherine Miller, Sarah Fowler, Luke Hounsome, Alan McNeill, Jim Adshead, John S McGrath
OBJECTIVES: To describe contemporary radical prostatectomy (RP) practice using the British Association of Urological Surgeons (BAUS) data and audit project and to observe differences in practice in relation to surgeon or centre case volume. PATIENTS AND METHODS: Data on 13,920 Radical Prostatectomy (RP) procedures performed by 178 surgeons across 86 centres were recorded on the BAUS data and audit platform between 1st January 2014 and 31st December 2015. This equates to approximately 95% of total RPs performed over this period when compared to HES (Hospital Episode Statistics) data...
February 1, 2018: BJU International
Motohiko Sugi, Hidefumi Kinoshita, Takashi Yoshida, Hisanori Taniguchi, Takao Mishima, Kenji Yoshida, Masaaki Yanishi, Yoshihiro Komai, Masato Watanabe, Tadashi Matsuda
OBJECTIVE: Radical prostatectomy is associated with complications including urinary incontinence. A significant association between specific features of the vesicourethral anastomosis and urinary incontinence after radical prostatectomy has been demonstrated. The aim of this study was to identify the most useful predictor of postoperative urinary incontinence after robot-assisted laparoscopic radical prostatectomy (RALP) according to the features of the vesicourethral anastomosis as determined by postoperative cystography...
February 1, 2018: Scandinavian Journal of Urology
Rie Oyama, Kimihiko Masui, Kodai Hattahara, Akihiro Hamada, Yasumasa Shichiri
We investigated the surgical outcome for robotic-assisted laparoscopic radical prostatectomy (RALP) withinitial 70 prostate cancer cases performed by a single surgeon between June 2014 and May 2016. The surgeon had a previous experience of more than 400 cases of laparoscopic radical prostatectomy (LRP). Comparative study of the surgical outcome was made between the first 35 patients (group 1) and the second 35 patients (group 2). The console time without lymph node dissection significantly decreased from group 1 to 2 (193 min vs 158 min, p=0...
December 2017: Hinyokika Kiyo. Acta Urologica Japonica
Anna Wallerstedt, Tommy Nyberg, Stefan Carlsson, Thordis Thorsteinsdottir, Johan Stranne, Stavros I Tyritzis, Karin Stinesen Kollberg, Jonas Hugosson, Anders Bjartell, Ulrica Wilderäng, Peter Wiklund, Gunnar Steineck, Eva Haglind
BACKGROUND: Surgery for prostate cancer has a large impact on quality of life (QoL). OBJECTIVE: To evaluate predictors for the level of self-assessed QoL at 3 mo, 12 mo, and 24 mo after robot-assisted laparoscopic (RALP) and open radical prostatectomy (ORP). DESIGN, SETTING, AND PARTICIPANTS: The LAParoscopic Prostatectomy Robot Open study, a prospective, controlled, nonrandomised trial of more than 4000 men who underwent radical prostatectomy at 14 centres...
January 20, 2018: European Urology Focus
Abbas Basiri, Jean Jmch de la Rosette, Shahin Tabatabaei, Henry H Woo, M Pilar Laguna, Hamidreza Shemshaki
PURPOSE: This study is a systematic analysis of the evidence regarding oncological, perioperative and postoperative outcomes and the cost of open retropubic radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic radical prostatectomy (RALP). METHODS: Summary data was abstracted from 104 original research articles representing 227,400 patients. PubMed/Medline, Scopus, Google Scholar, EMBASE and the Cochrane Library were reviewed in December 2016...
January 23, 2018: World Journal of Urology
Naohiro Kajiwara, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda
PURPOSE: To discuss the cost-benefit performance (CBP) and establish a medical fee system for robotic-assisted thoracic surgery (RATS) under the Japanese National Health Insurance System (JNHIS), which is a system not yet firmly established. METHODS: All management steps for RATS are identical, such as preoperative and postoperative management. This study examines the CBP based on medical fees of RATS under the JNHIS introduced in 2016. RESULTS: Robotic-assisted laparoscopic prostatectomy (RALP) and robotic-assisted partial nephrectomy (RAPN) now receive insurance reimbursement under the category of use of support devices for endoscopic surgery ($5420 and $3485, respectively)...
January 17, 2018: Annals of Thoracic and Cardiovascular Surgery
Ida Johnson, Fredrik Ottosson, Lien My Diep, Rolf Eigil Berg, Jon-Roar Hoff, Nicolai Wessel, Lars Magne Eri, Viktor Berge
OBJECTIVES: To compare oncological outcomes and complication rates based on the Clavien classification between laparoscopic radical prostatectomies (LRP) and robot-assisted laparoscopic radical prostatectomies (RALP). MATERIAL AND METHODS: In a prospective quality registry clinical data were consecutively entered for 544 LRP and 1081 RALP patients operated from 2003 to the end of 2012. Complications within 90 days postoperatively were assessed according to the Clavien classification and compared between LRP and RALP patients...
January 15, 2018: Scandinavian Journal of Urology
Hannah Wenger, Aria Razmaria, Scott Eggener, Jay D Raman
Background and Objectives: Loss of erectile function is common after prostatectomy, and surgeons have long sought techniques that reduce this adverse outcome. This study was conducted to assess erectile function after robot-assisted laparoscopic prostatectomy, with and without hydrodissection (HD) of the neurovascular bundles (NVBs). Methods: Using a database of 335 consecutive RALP procedures conducted by 2 surgeons, we identified all nerve-sparing surgeries performed by HD or standard dissection (SD)...
October 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Mohannad Hosny, Bhavan Rai, Feras Aljaafari, Samita Agarwal, Thomas McNicholas, Gregory Boustead, Thimothy Lane, James Adshead, Nikhil Vasdev
Objectives: Traditionally anterior prostatic fat (APF) hasn't been included in pelvic lymph node (LN) dissection templates following radical prostatectomy. In this study we evaluate the incidence of lymphoid tissue in the APF and the incidence of LN metastasis in APF in patients who have undergone robotic-assisted laparoscopic radical prostatectomy (RALP). Methods: A prospective database of RALP has been maintained between January 2010 and September 2015. APF is routinely excised and sent separately for histopathological evaluation to identify lymphoid tissue and metastatic prostate cancer...
November 2017: Current Urology
Young Dong Yu, Minseung Lee, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, Sangchul Lee
AIM: To evaluate the effects of prostatic apex shape variations on positive apical margin (PAM) rate after radical prostatectomy (RP) by undertaking a comparative study of robot-assisted laparoscopic radical prostatectomy (RALP) vs open radical prostatectomy (ORP). PATIENTS AND METHODS: A total of 3324 cases of RP (1004 ORP and 2320 RALP) from January 2004 to March 2017 were retrospectively reviewed. All patients underwent preoperative MRI and the cohorts were stratified into four categories according to prostatic apical shape at the midsagittal plane...
January 2018: Journal of Endourology
Karol Axcrona, Rasmus Nilsson, Bjørn Brennhovd, Øystein Sørebø, Sophie D Fosså, Alv A Dahl
BACKGROUND: Recently, the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) was recommended for the assessment of adverse effects after the treatment of prostate cancer without clear reasons. This decision encouraged us to review the questionnaire development from the UCLA Prostate Cancer Index (UCLA-PCI) to the EPIC-16 CP with a focus on psychometric properties. We also reviewed PubMed for papers concerning such properties of the EPIC-26 since 2012 (latest review in 2011)...
December 2, 2017: BMC Urology
Yasmin Abu-Ghanem, Zohar Dotan, Jacob Ramon, Dorit E Zilberman
Retzius space sparing (RSS) during laparoscopic robot-assisted radical prostatectomy (RALP) has been offered as an approach that reduces perioperative complications and enables faster gaining of full urinary continence due to bladder anatomy preservation. Retro and transperitoneal techniques have been proposed, whereby RSS has been implemented. We sought to explore whether Retzius space reconstruction (RSR) following transperitoneal RALP will be an advantageous step as well. A prospective registry database of 102 consecutive transperitoneal RALP cases performed by a single surgeon was reviewed...
November 27, 2017: Journal of Robotic Surgery
Aldo Brassetti, Flavia Proietti, Antonio Cardi, Antonio De Vico, Antonio Iannello, Alberto Pansadoro, Aldo Scapellato, Tommaso Riga, Paolo Emiliozzi, Gianluca D'Elia
The indwelling urinary catheter (UC) is a significant bother for men after radical prostatectomy (RP) and should be removed as soon as possible without jeopardizing the outcome. Our aim was to assess the feasibility and safety of its removal on postoperative day (POD) 2 after robot-assisted laparoscopic RP (RALP). A consecutive series of patients undergoing RALP for localized prostate cancer (PCa) were prospectively enrolled. Inclusion criteria were: no bladder-neck reconstruction, watertight urethrovesical anastomosis at 150 ml filling, ≤ 200 ml of intraoperative bleeding, ≤ 80 ml of fluid from the drain on POD 1, clear urine from the UC on POD 2...
November 25, 2017: Journal of Robotic Surgery
Nelly Tan, Luyao Shen, Pooria Khoshnoodi, Héctor E Alcalá, Weixia Yu, William Hsu, Robert E Reiter, David Y Lu, Steven S Raman
OBJECTIVE: To identify the clinical and MRI variables predictive of biochemical recurrence (BCR) after robotic assisted radical prostatectomy (RALP) in patients who underwent multi-parametric 3 Tesla prostate MR Imaging. METHODS: An IRB approved, HIPAA compliant, a single arm observational study with 3T mpMRI prior to RALP from December 2009 until March 2016 was performed. Clinical, MRI, pathological information and clinical outcome were compiled. Biochemical recurrence was defined as PSA greater > 0...
November 8, 2017: Journal of Urology
Takashi Kobayashi, Kent Kanao, Motoo Araki, Naoki Terada, Yasuyuki Kobayashi, Atsuro Sawada, Takahiro Inoue, Shin Ebara, Toyohiko Watanabe, Tomomi Kamba, Makoto Sumitomo, Yasutomo Nasu, Osamu Ogawa
BACKGROUND: Introducing a new surgical technology may affect behaviors and attitudes of patients and surgeons about clinical practice. Robot-assisted laparoscopic radical prostatectomy (RALP) was approved in 2012 in Japan. We investigated whether the introduction of this system affected the treatment of organ-confined prostate cancer (PCa) and the use of radical prostatectomy (RP). METHODS: We conducted a retrospective multicenter study on 718 patients with clinically determined organ-confined PCa treated at one of three Japanese academic institutions in 2011 (n = 338) or 2013 (n = 380)...
November 11, 2017: International Journal of Clinical Oncology
George Mirmilstein, Bhavan Prasad Rai, Olayinka Gbolahan, Vinaya Srirangam, Ashish Narula, Samita Agarwal, Tim M Lane, Nikhil Vasdev, James Adshead
OBJECTIVES: To evaluate the neurovascular structure-adjacent frozen-section examination (NeuroSAFE) technique in a British setting in men undergoing robot-assisted laparoscopic radical prostatectomy (RALP) . PATIENTS AND METHODS: We retrospectively analysed our prospectively maintained database of patients who underwent RALP between November 2008 and February 2017. We examined preoperative pathological and functional parameters, intraoperative nerve sparing (NS), postoperative histology, as well as functional and oncological follow-up...
November 10, 2017: BJU International
Se Yun Kwon, Jun Nyung Lee, Yun-Sok Ha, Seock Hwan Choi, Tae-Hwan Kim, Tae Gyun Kwon
PURPOSE: To present modified RRP using the same method as RALP and compare its surgical outcomes with RALP. MATERIALS AND METHODS: Demographics, perioperative and functional outcomes of the 322 patients that underwent RRP (N=99) or RALP (N=223) at our institution from January 2011 through June 2013 were evaluated retrospectively. Postoperative incontinence and erectile dysfunction are involved functional outcomes. During the modified procedure, the bladder neck was dissected first as for RALP...
November 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Aldo Brassetti, Riccardo Lombardo, Paolo Emiliozzi, Antonio Cardi, De Vico Antonio, Iannello Antonio, Scapellato Aldo, Riga Tommaso, Pansadoro Alberto, D'Elia Gianluca
OBJECTIVES: To analyse the performance of Prostate specific antigen density (PSAD) as a predictor of upstaging and Prognostic Grade Group (PGG) upgrading. METHODS: we retrospectively evaluated data on men with prostate PCa treated with robotic radical prostatectomy (RALP) at our center in 2014-2015. Preoperative PSAD was calculated. Bioptic and pathologic PGGs were also considered in the analysis. We defined upgrading any increase in PGG after RALP; upstaging was the pathological diagnosis of a pT≥3a PCa clinically unsuspected...
October 12, 2017: Urology
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