Endoscopic Extraperitoneal Radical Prostatectomy After Previous Transurethral Resection of Prostate: Oncologic and Functional Outcomes of 100 Cases

Do, Minh; Haefner, Tim; Liatsikos, Evangelos; Kallidonis, Panagiotis; Hicks, James; Dietel, Anja; Horn, Lars‐Christian; Robert, René; Stolzenburg, Jens‐Uwe

doi:10.1016/j.urology.2009.09.009

Cited by 17 publications

(27 citation statements)

References 17 publications

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“…Altered bladder neck anatomy can make the, often challenging, posterior bladder neck dissection even more difficult due to post TURP fibrosis. Do et al 45,46 recently reported 100 cases of extraperitoneal LRP following TURP and reported a higher overall complication rate (14 vs 9.35%) and transfusion rate (3 vs 0.6%) compared with their own series of 2000 previously reported LRPs. The higher complication rate appeared to correlate with a higher rate of anastomotic urine leaks secondary to difficult bladder neck dissections.…”

Section: Robotic Surgery Following Turpmentioning

confidence: 97%

“…First, Colombo et al 49 reported that the dissection and preservation of the urethral stump integrity constantly appeared the most difficult step in open surgery. Some investigators report that periprostatic fibrotic tissue renders the nerve-sparing procedure a difficult task; 45,49 however Eden et al 50 did not report the same difficulty. Finally, residual prostatic tissue could only be removed en bloc in 28% of cases.…”

Section: Robotic Surgery Following Turpmentioning

confidence: 99%

“…49 How LRP or open prostatectomy following TURP compare to RARP remains to be answered. At present a number of groups 45,51 recommend performing LRP after at least 3 months after TURP and there is no reason to believe that this would not be a reasonable interval in RARP.…”

Section: Robotic Surgery Following Turpmentioning

confidence: 99%

See 2 more Smart Citations

Overcoming the challenges of robot-assisted radical prostatectomy

Goldstraw¹,

Challacombe

Patil

et al. 2011

Prostate Cancer Prostatic Dis

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Section: Robotic Surgery Following Turpmentioning

confidence: 97%

Section: Robotic Surgery Following Turpmentioning

confidence: 99%

See 1 more Smart Citation

Overcoming the challenges of robot-assisted radical prostatectomy

Goldstraw¹,

Challacombe

Patil

et al. 2011

Prostate Cancer Prostatic Dis

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“…Radical prostatectomy for incidental prostate cancer, open or laparoscopic, is reported to have satisfactory oncologic outcome but functional outcome is inferior compared with the patients without history of TURP [7][8][9][10][11]. Thus, in the management of incidental prostate cancer, postoperative morbidities resulted from probable overtreatment might become more important compared with T1c cancer.…”

Section: Discussionmentioning

confidence: 99%

Incidental Prostate Cancer: Predictors of Progression and Strategies of Management Based on Prostate-Specific Antigen

Morita¹,

Matsuura

2014

JCTR

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Abstract:We studied predictors for the progression of incidental prostate cancer (PCa) to optimize the management strategies that are still controversial in the era of prostate-specific antigen (PSA). We performed advanced transurethral resection of the prostate (TURP) in 995 patients with benign prostate hyperplasia (BPH). Of these, 226 patients (22.7%) had incidental PCa. Included in the present study were 146 patients followed up for two years or longer. In the treated group of 26 patients whose PSA elevated, we performed radical transurethral resection of PCa (TURPCa) in 23 patients, palliative TURP in one, and endocrine therapy in two. Between the observed and treated groups, statistical differences were noted in PSA related parameters: preoperative PSA (Pre PSA), PSA three months after surgery (Post PSA), % Post PSA/Pre PSA (%PSA ratio), and PSA density (PSAD). No differences were noted in the clinical stage (T1a, T1b) and Gleason scores. Of 23 patients underwent radical TURPCa, one had pT0 disease, one showed PSA failure, and 19 had stable PSA. It may be rational and practical to decide the treatment strategy of incidental PCa based on PSA changes before and after TURP rather than Gleason scores or clinical stages.

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“…Rozet et al (9), Stolzenburg et al (10), Eden et al (11) and Do et al (12) have reported their encouraging experiences and results of laparoscopic radical prostatectomy. The majority of our perioperative results were analogical with data from the European studies (Table I).…”

Section: Discussionmentioning

confidence: 99%

Oncological and functional results of extraperitoneal laparoscopic radical prostatectomy

Zheng

Zhang

et al. 2012

Oncology Letters

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Abstract. The oncological and functional results of 329 cases in a population treated with extraperitoneal laparoscopic radical prostatectomy (ELRP) were evaluated retrospectively. A total of 329 inconsecutive patients with prostate cancer (PCa) who underwent ELRP were retrospectively analyzed. The median initial prostate-specific antigen (PSA) level was 17.35 ng/ml. The median biopsy Gleason score was 7.77. Patients with a T2 or T3a clinical stage had received preoperative neoadjuvant hormonal therapy (NHT) for 3 to 9 months prior to ELRP. No conversion or re-intervention were observed. The median time for anastomosis, surgery time and postoperative catheterization time were 13.0 min, 90.0 min and 6 days, respectively. The median estimated blood loss was 75 ml. There were 12 temporary urinary leakages requiring prolonged catheterization to 14 days. There was 1 case of deep vein thrombosis, 1 case of alimentary tract hemorrhage and 7 cases of anterior urethral stricture. The median follow-up time was 27 months. A total of 17 patients were lost during the follow-up period. No rectal injury, lymphocele, incision hernia, postoperative persistent urinary leak or anastomotic stricture occurred. Younger patients (≤67 years of age) had a more rapid recovery of continence and a better postoperative potency. The overall positive surgical margin rate was 16.7%, which correlated with the pathological stage and Gleason score, respectively (both P<0.001). A total of 89 (28.6%) patients were diagnosed with biochemical recurrence. The initial PSA value, PSM, pathological stage and Gleason score were identified as independent prognostic factors for biochemical recurrence-free survival using multivariate analysis. Our results demonstrated that preoperative NHT had significant effects on the pathological Gleason score (P<0.001) and surgical margin (P=0.027), but no significant impact on biochemical recurrence (P=0.202). The reproducibility of ELRP has been proven as a reliable curative treatment in Western countries during the last 15 years. Due to the increase in PCa patients, the results of our study may aid surgeons who use ELRP for the first time.

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Endoscopic Extraperitoneal Radical Prostatectomy After Previous Transurethral Resection of Prostate: Oncologic and Functional Outcomes of 100 Cases

Cited by 17 publications

References 17 publications

Overcoming the challenges of robot-assisted radical prostatectomy

Overcoming the challenges of robot-assisted radical prostatectomy

Incidental Prostate Cancer: Predictors of Progression and Strategies of Management Based on Prostate-Specific Antigen

Oncological and functional results of extraperitoneal laparoscopic radical prostatectomy

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