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Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy

INTRODUCTION: The objective of this study is to compare intrafascial nerve-sparing (NS), interfascial NS and non-NS prostatecomy specimens to assess the feasibility of NS technique in Robot-assisted radical prostatectomies (RARP). MATERIALS AND METHODS: The records of the first 43 consecutive patien...

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Autores principales: Tanaka, Kazushi, Shigemura, Katsumi, Hinata, Nobuyuki, Muramaki, Mototsugu, Miyake, Hideaki, Fujisawa, Masato
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120212/
https://www.ncbi.nlm.nih.gov/pubmed/25097311
http://dx.doi.org/10.4103/0970-1591.128500
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author Tanaka, Kazushi
Shigemura, Katsumi
Hinata, Nobuyuki
Muramaki, Mototsugu
Miyake, Hideaki
Fujisawa, Masato
author_facet Tanaka, Kazushi
Shigemura, Katsumi
Hinata, Nobuyuki
Muramaki, Mototsugu
Miyake, Hideaki
Fujisawa, Masato
author_sort Tanaka, Kazushi
collection PubMed
description INTRODUCTION: The objective of this study is to compare intrafascial nerve-sparing (NS), interfascial NS and non-NS prostatecomy specimens to assess the feasibility of NS technique in Robot-assisted radical prostatectomies (RARP). MATERIALS AND METHODS: The records of the first 43 consecutive patients (86 prostatic sides (lobe) who underwent NS RARP (6 intrafascial NS, 46 interfacial NS, 34 non-NS) were reviewed and histopathological examinations were performed. The presence and distribution of periprostatic neurovascular structures were histologically evaluated using mid-gland section of each prostate lobe in the prostatectomy specimen and it was immunostained with the S-100 antibody for quantitative analysis of nerves. RESULTS: The average number of nerve fibers per prostatic half was 37.2 ± 20.6. The number of resected peri-prostatic nerves counted was 13.7 ± 13.5, 30.5 ± 15.0 and 50.4 ± 20.4 in intrafascial NS, interfascial NS and non-NS specimens, respectively. The difference in the number of nerve bundle counts in the three groups was statistically significant (P < 0.05). Patients with urinary continence at 6 months after surgery had significantly less number of nerve fibers resected with the prostate than the incontinence group (P = 0.013) and the number of nerve fibers resected in the potent group were lower than in the impotent group but did not reach statistical significance (P = 0.057). CONCLUSIONS: Our study showed that NS RARP could be performed according to surgeons’ intention (intrafascial, interfascial or non-NS) and urinary continence significantly correlated to the number of nerve fibers resected with the prostate.
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spelling pubmed-41202122014-08-05 Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy Tanaka, Kazushi Shigemura, Katsumi Hinata, Nobuyuki Muramaki, Mototsugu Miyake, Hideaki Fujisawa, Masato Indian J Urol Original Article INTRODUCTION: The objective of this study is to compare intrafascial nerve-sparing (NS), interfascial NS and non-NS prostatecomy specimens to assess the feasibility of NS technique in Robot-assisted radical prostatectomies (RARP). MATERIALS AND METHODS: The records of the first 43 consecutive patients (86 prostatic sides (lobe) who underwent NS RARP (6 intrafascial NS, 46 interfacial NS, 34 non-NS) were reviewed and histopathological examinations were performed. The presence and distribution of periprostatic neurovascular structures were histologically evaluated using mid-gland section of each prostate lobe in the prostatectomy specimen and it was immunostained with the S-100 antibody for quantitative analysis of nerves. RESULTS: The average number of nerve fibers per prostatic half was 37.2 ± 20.6. The number of resected peri-prostatic nerves counted was 13.7 ± 13.5, 30.5 ± 15.0 and 50.4 ± 20.4 in intrafascial NS, interfascial NS and non-NS specimens, respectively. The difference in the number of nerve bundle counts in the three groups was statistically significant (P < 0.05). Patients with urinary continence at 6 months after surgery had significantly less number of nerve fibers resected with the prostate than the incontinence group (P = 0.013) and the number of nerve fibers resected in the potent group were lower than in the impotent group but did not reach statistical significance (P = 0.057). CONCLUSIONS: Our study showed that NS RARP could be performed according to surgeons’ intention (intrafascial, interfascial or non-NS) and urinary continence significantly correlated to the number of nerve fibers resected with the prostate. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4120212/ /pubmed/25097311 http://dx.doi.org/10.4103/0970-1591.128500 Text en Copyright: © Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Tanaka, Kazushi
Shigemura, Katsumi
Hinata, Nobuyuki
Muramaki, Mototsugu
Miyake, Hideaki
Fujisawa, Masato
Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
title Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
title_full Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
title_fullStr Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
title_full_unstemmed Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
title_short Histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
title_sort histological evaluation of nerve sparing technique in robotic assisted radical prostatectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4120212/
https://www.ncbi.nlm.nih.gov/pubmed/25097311
http://dx.doi.org/10.4103/0970-1591.128500
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