Does the Presence of Median Lobe Affect Outcomes of Robot-Assisted Laparoscopic Radical Prostatectomy?
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Citações na Scopus
24
Tipo de produção
article
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
MARY ANN LIEBERT INC
Autores
CHAUHAN, Sanket
ORVIETO, Marcelo A.
SIVARAMAN, Ananthakrishnan
PALMER, Kenneth J.
ROCCO, Bernardo
COUGHLIN, Geoff
HASSAN, Rayan El
Citação
JOURNAL OF ENDOUROLOGY, v.26, n.3, p.264-270, 2012
Resumo
Purpose: To determine whether the presence of median lobe (ML) affects perioperative outcomes, positive surgical margin (PSM) rates, and recovery of urinary continence after robot-assisted radical prostatectomy (RARP). Patients and Methods: We analyzed 1693 consecutive patients undergoing RARP performed by a single surgeon. Patients were analyzed in two groups based on the presence or not of a ML identified during RARP. Perioperative outcomes, PSM rates, and recovery of urinary continence were compared between the groups. Continence was assessed using validated questionnaires, and it was defined as the use of ""no pads"" postoperatively. Results: A ML was identified in 323 (19%) patients. Both groups had similar estimated blood loss, length of hospital stay, pathologic stage, complication rates, anastomotic leakage rates, overall PSM rates, and PSM rate at the bladder neck. The median overall operative time was slightly greater in patients with ML (80 vs 75 min, P < 0.001); however, there was no difference in the operative time when stratifying this result by prostate weight. Continence rates were also similar between patients with and without ML at 1 week (27.8% vs 27%, P = 0.870), 4 weeks (42.3% vs 48%, P = 0.136), 12 weeks (82.5% vs 86.8%, P = 0.107), and 24 weeks (91.5% vs 94.1%, P = 0.183) after catheter removal. Finally, the median time to recovery of continence was similar between the groups (median: 5 wks, 95% confidence interval [CI]: 4.41-5.59 vs median: 5 wks, CI 4.66-5.34; log rank test, P = 0.113). Conclusion: The presence of a ML does not affect outcomes of RARP performed by an experienced surgeon.
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Referências
- Binder J, 2001, BJU INT, V87, P408, DOI 10.1046/j.1464-410x.2001.00115.x
- Coelho RF, 2009, BJU INT, V104, P1428, DOI 10.1111/j.1464-410X.2009.08895.x
- Coelho RF, 2010, EUR UROL, V57, P945, DOI 10.1016/j.eururo.2010.02.001
- Coelho RF, 2011, EUR UROL, V59, P72, DOI 10.1016/j.eururo.2010.08.025
- Coughlin G, 2009, J ROBOT SURG, V1, P13
- Deliveliotis C, 2002, UROLOGY, V60, P855, DOI 10.1016/S0090-4295(02)01956-8
- Ficarra V, 2009, EUR UROL, V55, P1037, DOI 10.1016/j.eururo.2009.01.036
- Hayat HJ, 2007, ONCOLOGIST, V12, P20
- Jenkins LC, 2008, UROLOGY, V71, P810, DOI 10.1016/j.urology.2007.12.054
- Lee DJ, 2010, CAN J UROL, V17, P5200
- Lepor H, 2004, J UROLOGY, V171, P1216, DOI 10.1097/01.ju.0000113964.68020.a7
- Lin VC, 2009, BJU INT, V104, P878, DOI 10.1111/j.1464-410X.2009.08784.x
- Link BA, 2008, J UROLOGY, V180, P928, DOI 10.1016/j.juro.2008.05.029
- Meeks JJ, 2009, UROLOGY, V73, P323, DOI 10.1016/j.urology.2008.08.484
- Patel VR, 2009, EUR UROL, V56, P472, DOI 10.1016/j.eururo.2009.06.007
- Patel VR, 2005, J UROLOGY, V174, P269, DOI 10.1097/01.ju.0000162082.12962.40
- Selli C, 2004, SCAND J UROL NEPHROL, V38, P32, DOI 10.1080/00365590310017280
- Srougi M, 2001, J UROLOGY, V165, P815, DOI 10.1016/S0022-5347(05)66534-2
- Vickers AJ, 2009, LANCET ONCOL, V10, P475, DOI 10.1016/S1470-2045(09)70079-8
- Vickers AJ, 2007, J NATL CANCER I, V99, P1171, DOI 10.1093/jnci/djm060
- Wei JT, 2000, UROLOGY, V56, P899, DOI 10.1016/S0090-4295(00)00858-X