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Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes
Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) has emerged as a surgical option for patients with prostatic cancer in high-volume centers. The objective is to assess oncological and functional outcomes when implementing RS-RARP in a medium-volume center without previous experience of...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer London
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209308/ https://www.ncbi.nlm.nih.gov/pubmed/36633734 http://dx.doi.org/10.1007/s11701-022-01517-3 |
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author | Fonseca, Jorge Moraes-Fontes, Maria Francisca Rebola, Jorge Lúcio, Rui Almeida, Miguel Muresan, Ciprian Palmas, Artur Gaivão, Ana Matos, Celso Santos, Tiago Dias, Daniela Sousa, Inês Oliveira, Francisco Ribeiro, Ricardo Lopez-Beltran, Antonio Fraga, Avelino |
author_facet | Fonseca, Jorge Moraes-Fontes, Maria Francisca Rebola, Jorge Lúcio, Rui Almeida, Miguel Muresan, Ciprian Palmas, Artur Gaivão, Ana Matos, Celso Santos, Tiago Dias, Daniela Sousa, Inês Oliveira, Francisco Ribeiro, Ricardo Lopez-Beltran, Antonio Fraga, Avelino |
author_sort | Fonseca, Jorge |
collection | PubMed |
description | Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) has emerged as a surgical option for patients with prostatic cancer in high-volume centers. The objective is to assess oncological and functional outcomes when implementing RS-RARP in a medium-volume center without previous experience of robotic surgery. This is a prospective observational single-center study. Patients operated between July 2017 and April 2020 were divided into two consecutive groups, A and B, each with 104 patients. The surgeons had prior experience in laparoscopic surgery and underwent robotic training. Positive surgical margin (PSM) status, urinary continence, and erectile function projected by Kaplan–Meier curves, together with patient reported quality of life outcomes at 12 months post-surgery were documented. Median patient age was 63 years (IQR = 59–67), overall PSM rate were 33%, 28% for pT2 disease. Pre-operative values showed no significant difference between both groups. The rate of urinary continence dropped from 81 to 78% (SE = 5.7) (Group A) and from 90 to 72% (SE = 6.3) (Group B) using the International Consultation on Incontinence Questionnaire-Short Form. Baseline sexual function was regained in 41% (Group A) and 47% (Group B) of patients. The median Expanded Prostate Index Composite-26 total score decreased from 86 to 82. These outcomes relate favorably to prior reports. There was a clinically significant decrease in median operative time in the successive groups with post-operative complications occurring in less than 2% of surgical procedures overall. A 12-month follow-up suggests that RS-RARP may be safely introduced in a medium-volume center without previous experience of robotic surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11701-022-01517-3. |
format | Online Article Text |
id | pubmed-10209308 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer London |
record_format | MEDLINE/PubMed |
spelling | pubmed-102093082023-05-26 Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes Fonseca, Jorge Moraes-Fontes, Maria Francisca Rebola, Jorge Lúcio, Rui Almeida, Miguel Muresan, Ciprian Palmas, Artur Gaivão, Ana Matos, Celso Santos, Tiago Dias, Daniela Sousa, Inês Oliveira, Francisco Ribeiro, Ricardo Lopez-Beltran, Antonio Fraga, Avelino J Robot Surg Research Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) has emerged as a surgical option for patients with prostatic cancer in high-volume centers. The objective is to assess oncological and functional outcomes when implementing RS-RARP in a medium-volume center without previous experience of robotic surgery. This is a prospective observational single-center study. Patients operated between July 2017 and April 2020 were divided into two consecutive groups, A and B, each with 104 patients. The surgeons had prior experience in laparoscopic surgery and underwent robotic training. Positive surgical margin (PSM) status, urinary continence, and erectile function projected by Kaplan–Meier curves, together with patient reported quality of life outcomes at 12 months post-surgery were documented. Median patient age was 63 years (IQR = 59–67), overall PSM rate were 33%, 28% for pT2 disease. Pre-operative values showed no significant difference between both groups. The rate of urinary continence dropped from 81 to 78% (SE = 5.7) (Group A) and from 90 to 72% (SE = 6.3) (Group B) using the International Consultation on Incontinence Questionnaire-Short Form. Baseline sexual function was regained in 41% (Group A) and 47% (Group B) of patients. The median Expanded Prostate Index Composite-26 total score decreased from 86 to 82. These outcomes relate favorably to prior reports. There was a clinically significant decrease in median operative time in the successive groups with post-operative complications occurring in less than 2% of surgical procedures overall. A 12-month follow-up suggests that RS-RARP may be safely introduced in a medium-volume center without previous experience of robotic surgery. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11701-022-01517-3. Springer London 2023-01-12 2023 /pmc/articles/PMC10209308/ /pubmed/36633734 http://dx.doi.org/10.1007/s11701-022-01517-3 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Fonseca, Jorge Moraes-Fontes, Maria Francisca Rebola, Jorge Lúcio, Rui Almeida, Miguel Muresan, Ciprian Palmas, Artur Gaivão, Ana Matos, Celso Santos, Tiago Dias, Daniela Sousa, Inês Oliveira, Francisco Ribeiro, Ricardo Lopez-Beltran, Antonio Fraga, Avelino Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes |
title | Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes |
title_full | Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes |
title_fullStr | Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes |
title_full_unstemmed | Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes |
title_short | Retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes |
title_sort | retzius-sparing robot-assisted radical prostatectomy in a medium size oncological center holds adequate oncological and functional outcomes |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10209308/ https://www.ncbi.nlm.nih.gov/pubmed/36633734 http://dx.doi.org/10.1007/s11701-022-01517-3 |
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