A matched-pair comparison between bilateral intrafascial and interfascial nerve-sparing techniques in extraperitoneal laparoscopic radical prostatectomy

Zheng, Tao; Zhang, Xu; Ma, Xin; Li, Hongzhao; Gao, Jiang-Pin; Cai, Wei; Dong, Jun; Chen, Guangfu; Wang, Baojun; Shi, Taoping; Song, Erlin; Chen, Wei-Hao; Huang, Qingbo

doi:10.1038/aja.2012.157

Cited by 5 publications

(13 citation statements)

References 22 publications

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“…These six comparative trials included one RCT 7 , three prospective comparative trials 8 , 9 , 12 , and two retrospective comparative trials 10 , 11 . There were two studies 7 , 9 using laparoscopic RP, two studies 8 , 11 involving robot-assisted RP, and two studies 10 , 12 applying open retropubic RP. The definition of the ITR-NS and ITE-NS in the included studies is presented in Supplementary Table 2 .…”

Section: Resultsmentioning

confidence: 99%

“…Study sample sizes ranged from 41 8 and 420 12 . Studies were published from 2010 to 2015 in Europe 7 , 10 – 12 and Asia 8 , 9 . All the studies used bilateral nerve-sparing radical prostatectomy technique.…”

Section: Resultsmentioning

confidence: 99%

“… Reference Study Surgical approach No. of cases, type Age, yr PSA, ng/ml Size of prostate, ml pT2, % Gleason score 4–6, % Gleason score 7, % Gleason score 8–10, % Stolzenburg 7 RCT Laparoscopic 200 ITR-NS 60 (41–73) 6 (1.0–31) 40 (20–105) 89 51.5 24.5 21 200 ITE-NS 62 (41–75) 6.8 (0.6–24) 44.5 (16–166) 81 45.9 30.1 24 Ko 8 Prospective RARP 9 ITR-NS 52.44 ± 5.38 4.96 ± 1.26 49.94 ± 12.66 100 22.2 77.8 0 32 ITE-NS 59.05 ± 6.95 5.28 ± 2.17 59.09 ± 18.61 100 28.1 71.9 0 Zheng 9 Prospective Laparoscopic 65 ITR-NS 65 (56–70) 5.12 (2.90–7.85) — 86 — — 0 130 ITE-NS 65 (55–69) 5.98 (2.98–8.06) — 80 — — 0 Khoder 10 Retrospective Retropubic 203 ITR-NS 62.7 (35.9–82.1) 5.6 (0.3–9.9) — 93 66.4 32.7 0.9 163 ITE-NS 63.5 (41.1–77.6) 7.0 (0.6–15.0) — …”

Section: Resultsmentioning

confidence: 99%

“…Four studies 7 , 9 , 10 , 12 reported the postoperative urinary continence recovery rate at 3 mo; two studies 7 , 9 reported it at 6 mo; five studies 7 , 9 – 12 reported it at 12 mo; one study 12 reported it at 36 mo (Table 5 ). Heterogeneity was detected in the 3 mo time point ( p = 0.006, I 2 = 76%).…”

Section: Resultsmentioning

confidence: 99%

“… Study No. of cases, type Method Criterion 3 mo, % 6 mo, % 12 mo, % 36 mo, % Stolzenburg 7 200 ITR-NS ICS 0–1 pads/d 74 87.9 93.2 — 200 ITE-NS 63 76.2 90 — Zheng 9 65 ITR-NS Questionnaire 0–1 pads/d 80.4 87.5 96.6 — 130 ITE-NS 59.8 70.1 94 — Khoder 10 203 ITR-NS Questionnaire 0 pad/d 66 — 90 — 163 ITE-NS 68 — 86 — Ihsan-Tasci 11 200 ITR-NS Not described Only safety pads used — — 80.5 — 41 ITE-NS — — 80.4 — Khoder 12 239 ITR-NS Questionnaire 0 pad/d 56 — 70 85 181 ITE-NS 62 — 61 75 ITR-NS = intrafacial nerve sparing; ITE-NS = interfacial nerve sparing; ICS = International Continence Society.

Figure 2 Forest plot of ( a ) continence rates ( b ) sensitivity analysis for ITR-NS versus ITE-NS.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Intrafascial versus interfascial nerve sparing in radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis

Weng

Zeng

Sheng

et al. 2017

Sci Rep

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The present study aimed to systematically evaluate the effectiveness and safety of the intrafascial and interfascial nerve sparing (ITR-NS and ITE-NS) radical prostatectomy. PubMed, Embase, and Cochrane Library databases were searched for eligible studies. Meta-analysis with random-effects model was performed. Six comparative trials were selected and embraced in this research, including one randomized controlled trial, three prospective comparative trials, and two retrospective comparative trials. With regard to perioperative parameters, no significant association of operative time, blood loss, transfusion rates, duration of catheterization, and hospital stay existed between ITR-NS and ITE-NS. With respect to the functional results, ITR-NS had advantages in terms of both continence and potency recovery compared with ITE-NS. In reference to the oncologic results, the ITR-NS showed lower overall positive surgical margin (PSM) compared with ITE-NS but pT2 PSM and biochemical recurrence free rates were similar to the two surgical types. This study demonstrates that ITR-NS has better continence at 6 mo and 36 mo and better potency recovery at 6 mo and 12 mo postoperatively, regardless of the surgical technique. The cancer control of ITR-NS was also better than that of ITE-NS. This may be explained by the fact that patients in ITE-NS group present higher risk cancer than patients in ITR-NS group.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Figure 2 Forest plot of ( a ) continence rates ( b ) sensitivity analysis for ITR-NS versus ITE-NS.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Intrafascial versus interfascial nerve sparing in radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis

Weng

Zeng

Sheng

et al. 2017

Sci Rep

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Anatomic Foundations and Physiology of Erectile Function and Urinary Continence

Dalela

Menon

2016

Urinary Continence and Sexual Function After Robotic Radical Prostatectomy

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Comparison of intrafascial and non-intrafascial radical prostatectomy for low risk localized prostate cancer

Zhao

Zhu

et al. 2017

Sci Rep

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In this meta-analysis study, we compared the oncological and functional outcomes of intrafascial radical prostatectomy (IFRP) with non-intrafascial radical prostatectomy (NIFRP) in the treatment of patients with low risk localized prostate cancer (PCa). Relevant articles were identified by searching PubMed, EMBASE, Cochrane Library, Ovid, and the ISI Web of Knowledge databases. A total of 2096 patients were included from 7 eligible studies. Results of the pooled data showed that the oncological outcomes including gleason score, positive surgical margin and biochemical free survival rates were similar between the two groups. IFRP was superior to NIFRP with lower postoperative complication rates (RR 0.57, 95% CI 0.38, 0.85, p = 0.006), higher continence rates at 3 months post-operation (RR: 1.14; 95% CI, 1.04, 1.26; p = 0.006), and higher potency rates at 6 months (RR: 1.53; 95% CI, 1.07, 2.18; p = 0.02) and 12 months post-operation (RR: 1.38; 95% CI, 1.11, 1.73; p = 0.005). Additionally, there was a tendency towards higher potency rate in patients ≤65 years old compared with patients >65 years old after IFRP. Overall, these findings suggest that IFRP in young patients with low risk localized PCa had less postoperative complications, shortened time to return to continence and improved potency rate without compromising complete tumor control.

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A matched-pair comparison between bilateral intrafascial and interfascial nerve-sparing techniques in extraperitoneal laparoscopic radical prostatectomy

Cited by 5 publications

References 22 publications

Intrafascial versus interfascial nerve sparing in radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis

Intrafascial versus interfascial nerve sparing in radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis

Anatomic Foundations and Physiology of Erectile Function and Urinary Continence

Comparison of intrafascial and non-intrafascial radical prostatectomy for low risk localized prostate cancer

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