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

Zhao, Zhankui; Zhu, Haizhou; Yu, Honglian; Kong, Qingsheng; Fan, Chengjuan; Meng, Lin; Liu, Chuanxin; Ding, Xuanfeng

doi:10.1038/s41598-017-17929-3

Cited by 4 publications

(2 citation statements)

References 46 publications

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“…For novice surgeons, intrafascial radical prostatectomy other than the non-intrafascial technique was suggested in young patients with a low risk of localized prostate cancer. 17 The duration of catheter placement was slightly long in the single-knot group because two cases in the single-knot group had a catheter for longer than 1 month and surgeons with limited experienced wanted to guarantee anastomosis. Postoperative prostate-specific antigen levels were detectable because of the high positive margin rate, but this was acceptable for novice surgeons who had not overcome the learning curve.…”

Section: Discussionmentioning

confidence: 99%

Comparison between a novel knotless technique and the conventional single knot technique of laparoscopic radical prostatectomy by novice laparoscopists

Wang

et al. 2018

J Int Med Res

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ObjectivesThis study aimed to investigate a novel knotless technique for novice laparoscopists in traditional laparoscopic radical prostatectomy.MethodsWe studied 68 patients who had a novel technique performed in laparoscopic radical prostatectomy (knotless group) and 89 who had the conventional single knot technique (single knot group). The operations were all performed by novice laparoscopists with experience of fewer than 100 cases of laparoscopic radical prostatectomy. Knotless suture of the dorsal vein complex was conducted using a barbed self-retaining suture with three bites at the same location. The knotless urethrovesical anastomosis technique was conducted using a unidirectional single running fashion with a barbed self-retaining suture.ResultsThere were no significant differences in the estimated blood loss, complication rate, postoperative hospital stay, anastomotic leakage rate, continence at 6 months after surgery, and positive margin rate between the two groups. The mean anastomotic time (24.9 vs. 44.2 min), operative time (168.1 vs. 201.8 min), and duration of catheter placement (12.8 vs. 19.8 days) were shorter in the knotless group than in the single-knot group.ConclusionsThe knotless technique of laparoscopic radical prostatectomy is a safe and effective procedure.

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Section: Discussionmentioning

confidence: 99%

Comparison between a novel knotless technique and the conventional single knot technique of laparoscopic radical prostatectomy by novice laparoscopists

Wang

et al. 2018

J Int Med Res

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“…Zhao et al in a meta-analysis including 2096 patients from 7 eligible studies, compared the oncological and functional outcomes of intrafascial with non-intrafascial RP (including interfascial, extrafascial and no nerve-sparing approaches) in patients with low-risk localized prostate cancer. Meta-analysis demonstrated that the oncological outcomes were similar between the two groups, while the intrafascial approach was associated with lower postoperative complication rates, higher continence rates at 3 months and higher potency rates at 6 and 12 months following surgery, as compared to the non-intrafascial approaches [ 21 ].…”

Section: The Fascial Planes For Nsmentioning

confidence: 99%

Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes

Kyriazis

Spinos

Tsaturyan

et al. 2022

Cancers

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The purpose of this narrative review is to describe the different nerve-sparing techniques applied during radical prostatectomy and document their functional impact on postoperative outcomes. We performed a PubMed search of the literature using the keywords “nerve-sparing”, “techniques”, “prostatectomy” and “outcomes”. Other potentially eligible studies were retrieved using the reference list of the included studies. Nerve-sparing techniques can be distinguished based on the fascial planes of dissection (intrafascial, interfascial or extrafascial), the direction of dissection (retrograde or antegrade), the timing of the neurovascular bundle dissection off the prostate (early vs. late release), the use of cautery, the application of traction and the number of the neurovascular bundles which are preserved. Despite this rough categorisation, many techniques have been developed which cannot be integrated in one of the categories described above. Moreover, emerging technologies have entered the nerve-sparing field, making its future even more promising. Bilateral nerve-sparing of maximal extent, athermal dissection of the neurovascular bundles with avoidance of traction and utilization of the correct planes remain the basic principles for achieving optimum functional outcomes. Given that potency and continence outcomes after radical prostatectomy are multifactorial endpoints in addition to the difficulty in their postoperative assessment and the well-documented discrepancy existing in their definition, safe conclusions about the superiority of one technique over the other cannot be easily drawn. Further studies, comparing the different nerve-sparing techniques, are necessary.

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Evidence for novel tubular-bundle structures entangled in the fascia of the inner abdominal wall of a rat

Lee

2019

Micron

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

Cited by 4 publications

References 46 publications

Comparison between a novel knotless technique and the conventional single knot technique of laparoscopic radical prostatectomy by novice laparoscopists

Comparison between a novel knotless technique and the conventional single knot technique of laparoscopic radical prostatectomy by novice laparoscopists

Different Nerve-Sparing Techniques during Radical Prostatectomy and Their Impact on Functional Outcomes

Evidence for novel tubular-bundle structures entangled in the fascia of the inner abdominal wall of a rat

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