Evolution of robotic radical prostatectomy

Abstract

Objective To phenotypically characterize ADAMTS‐4– and ADAMTS‐5–double‐knockout mice, and to determine the effect of deletion of ADAMTS‐4 and ADAMTS‐5 on the progression of osteoarthritis (OA) in mice. Methods Mice lacking the catalytic domain of ADAMTS‐4 and ADAMTS‐5 were crossed to generate ADAMTS‐4/5–double‐knockout animals. Twelve‐week‐old and 1‐year‐old male and female ADAMTS‐4/5–double‐knockout mice were compared with age‐ and sex‐matched wild‐type (WT) mice by evaluating terminal body weights, organ weights, clinical pathology parameters, PIXImus mouse densitometry findings, and macroscopic and microscopic observations. ADAMTS‐4/5–double‐knockout mice were challenged by surgical induction of joint instability to determine the importance of these genes in the progression of OA. Articular and nonarticular cartilage explants from WT and ADAMTS‐4/5–double‐knockout mice were treated with interleukin‐1 (IL‐1) plus retinoic acid ex vivo, to examine proteoglycan degradation. Results There were no genotype‐related phenotype differences between ADAMTS‐4/5–double‐knockout and WT mice through 1 year of age, with the exception that female ADAMTS‐4/5–double‐knockout mice had a lower mean terminal body weight at the 12‐week time point. Eight weeks after surgical induction of joint instability, OA was significantly less severe in ADAMTS‐4/5–double‐knockout mice compared with WT mice. Following stimulation of cartilage explants with IL‐1 plus retinoic acid, aggrecanase‐mediated degradation in ADAMTS‐4/5–double‐knockout mice was ablated, to a level comparable with that in ADAMTS‐5–knockout mice. Conclusion Dual deletion of ADAMTS‐4 and ADAMTS‐5 generated mice that were phenotypically indistinguishable from WT mice. Deletion of ADAMTS‐4/5 provided significant protection against proteoglycan degradation ex vivo and decreased the severity of murine OA. These effects in the ADAMTS‐4/5–double‐knockout mice were comparable with those observed with deletion of ADAMTS‐5 alone.

Advances and future directions in management of prostate cancer

“…Therefore, due to the low incidence of progression, we can not accurately compare cancer specifi c survival in robotic and open patients. However, biochemical recurrence data is similar between studies evaluating patients undergoing minimally invasive and open surgical management [23]. At this point in time, we can conclude that robotic prostatectomy does not produce inferior oncological outcomes.…”

Biochemical outcomes after robot-assisted radical prostatectomy in patients with follow-up more than 5-years

“…[18][19][20] Even though these series reported favourable biochemical outcomes, most were based on short-term follow-ups with medians less than 3 years. Recently, Menon et al 12 published the oncologic outcomes of 1384 patients who underwent RARP with a median 5-year follow-up.…”

Outcomes after robot-assisted laparoscopic radical prostatectomy

“…The largest series of RALRP, from the Henry Ford Centre in Detroit involving 2 766 patients with a follow-up of up to 5 years, has been reported by Badani et al [27]. The proportions of patients in low-, intermediate-and highrisk categories were 69.1%, 22.7% and 8.2%, respectively.…”

“…The Clavien system grades complications from I to V. Grade I indicates any deviation from the normal postoperative care plan; grade II complications require medical intervention; grade III requires surgical or radiological intervention; grade IV is a life-threatening complication requiring intensive therapy unit (ITU) management; and grade V is death. Two papers focused entirely on complications relating to RALRP [38,39], and two other papers [23,27] recommended the adoption of the Clavien system for reporting complications. Table 2 summarizes the findings from these publications with respect to complications.…”