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Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy
OBJECTIVES: To describe a novel dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy and to evaluate its postoperative outcomes. METHODS: A total of 109 patients who underwent laparoscopic radical prostatectomy by a single surgeon were evaluated,...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664026/ https://www.ncbi.nlm.nih.gov/pubmed/23039276 http://dx.doi.org/10.1111/j.1442-2042.2012.03181.x |
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author | Hoshi, Akio Usui, Yukio Shimizu, Yuuki Tomonaga, Tetsuro Kawakami, Masayoshi Nakajima, Nobuyuki Hanai, Kazuya Nomoto, Takeshi Terachi, Toshiro |
author_facet | Hoshi, Akio Usui, Yukio Shimizu, Yuuki Tomonaga, Tetsuro Kawakami, Masayoshi Nakajima, Nobuyuki Hanai, Kazuya Nomoto, Takeshi Terachi, Toshiro |
author_sort | Hoshi, Akio |
collection | PubMed |
description | OBJECTIVES: To describe a novel dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy and to evaluate its postoperative outcomes. METHODS: A total of 109 patients who underwent laparoscopic radical prostatectomy by a single surgeon were evaluated, including 44 patients with dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy, 20 patients with conventional intrafascial nerve-sparing laparoscopic radical prostatectomy and 45 patients with non-nerve-sparing laparoscopic radical prostatectomy. Functional outcomes were evaluated using a self-administered questionnaire (Expanded Prostate Cancer Index Composite). Continence was defined as zero to one security pad per day. Oncological outcomes were evaluated based on positive surgical margin. RESULTS: In the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group, the continence rate was 57%, 77% and 95% at 1, 3 and 12 months, respectively. The continence rate in the conventional intrafascial nerve-sparing laparoscopic radical prostatectomy group was 37%, 63% and 90%, and in the non-nerve-sparing laparoscopic radical prostatectomy group it was 23%, 57% and 82% at 1, 3, and 12 months, respectively. The dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group showed a significantly earlier recovery from incontinence compared with that in the conventional intrafascial nerve-sparing laparoscopic radical prostatectomy and non-nerve-sparing laparoscopic radical prostatectomy groups (log–rank test, P = 0.044 and P < 0.001). Similarly, the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group tended to show a more early recovery in relation to urinary function of the Expanded Prostate Cancer Index Composite. Regarding sexual function, there were no significant differences between the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy and conventional intrafascial nerve-sparing laparoscopic radical prostatectomy groups. In pT2 patients, the positive surgical margin rate of the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group (11%) was similar to that of the other two groups (conventional intrafascial nerve-sparing laparoscopic radical prostatectomy 7%; non-nerve-sparing laparoscopic radical prostatectomy 11%). CONCLUSIONS: The dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy technique provides early recovery from incontinence without adversely affecting the oncological outcome. |
format | Online Article Text |
id | pubmed-3664026 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-36640262013-05-28 Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy Hoshi, Akio Usui, Yukio Shimizu, Yuuki Tomonaga, Tetsuro Kawakami, Masayoshi Nakajima, Nobuyuki Hanai, Kazuya Nomoto, Takeshi Terachi, Toshiro Int J Urol Original Articles Clinical Investigations OBJECTIVES: To describe a novel dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy and to evaluate its postoperative outcomes. METHODS: A total of 109 patients who underwent laparoscopic radical prostatectomy by a single surgeon were evaluated, including 44 patients with dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy, 20 patients with conventional intrafascial nerve-sparing laparoscopic radical prostatectomy and 45 patients with non-nerve-sparing laparoscopic radical prostatectomy. Functional outcomes were evaluated using a self-administered questionnaire (Expanded Prostate Cancer Index Composite). Continence was defined as zero to one security pad per day. Oncological outcomes were evaluated based on positive surgical margin. RESULTS: In the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group, the continence rate was 57%, 77% and 95% at 1, 3 and 12 months, respectively. The continence rate in the conventional intrafascial nerve-sparing laparoscopic radical prostatectomy group was 37%, 63% and 90%, and in the non-nerve-sparing laparoscopic radical prostatectomy group it was 23%, 57% and 82% at 1, 3, and 12 months, respectively. The dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group showed a significantly earlier recovery from incontinence compared with that in the conventional intrafascial nerve-sparing laparoscopic radical prostatectomy and non-nerve-sparing laparoscopic radical prostatectomy groups (log–rank test, P = 0.044 and P < 0.001). Similarly, the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group tended to show a more early recovery in relation to urinary function of the Expanded Prostate Cancer Index Composite. Regarding sexual function, there were no significant differences between the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy and conventional intrafascial nerve-sparing laparoscopic radical prostatectomy groups. In pT2 patients, the positive surgical margin rate of the dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy group (11%) was similar to that of the other two groups (conventional intrafascial nerve-sparing laparoscopic radical prostatectomy 7%; non-nerve-sparing laparoscopic radical prostatectomy 11%). CONCLUSIONS: The dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy technique provides early recovery from incontinence without adversely affecting the oncological outcome. Blackwell Publishing Ltd 2013-05 2012-10-08 /pmc/articles/PMC3664026/ /pubmed/23039276 http://dx.doi.org/10.1111/j.1442-2042.2012.03181.x Text en © 2013 The Japanese Urological Association http://creativecommons.org/licenses/by/2.5/ Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation. |
spellingShingle | Original Articles Clinical Investigations Hoshi, Akio Usui, Yukio Shimizu, Yuuki Tomonaga, Tetsuro Kawakami, Masayoshi Nakajima, Nobuyuki Hanai, Kazuya Nomoto, Takeshi Terachi, Toshiro Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy |
title | Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy |
title_full | Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy |
title_fullStr | Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy |
title_full_unstemmed | Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy |
title_short | Dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy |
title_sort | dorsal vein complex preserving technique for intrafascial nerve-sparing laparoscopic radical prostatectomy |
topic | Original Articles Clinical Investigations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664026/ https://www.ncbi.nlm.nih.gov/pubmed/23039276 http://dx.doi.org/10.1111/j.1442-2042.2012.03181.x |
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