Laparoscopic Radical Prostatectomy in Renal Transplant Recipients

Robert, G.; Elkentaoui, Hicham; Pasticier, G.; Couzi, Lionel; Merville, Pierre; Ravaud, Alain; Ballanger, P.; Ferrière, Jean-Marie; Wallerand, Hervé

doi:10.1016/j.urology.2009.04.053

Cited by 35 publications

(38 citation statements)

References 16 publications

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Section: Discussionmentioning

confidence: 99%

“…Transperitoneal technique was the most frequent approach, but extraperitoneal series have been reported as well [9]. Robert et al [9] compared laparoscopic radical prostatectomy in 9 renal transplant recipients with 164 control patients. No differences were found in oncological outcomes but they presented a higher incidence of rectal injury (22.2 vs. 1.8%, p = 0.022) due to a very difficult dissection of posterior surface.…”

Section: Discussionmentioning

confidence: 99%

“…With the development of laparoscopic prostatectomy surgery, some small series have been reported in renal transplant recipients [9,10,11,12,13,14], with successful outcomes, being a reproducible and a safe procedure in experimented centers.…”

Section: Introductionmentioning

confidence: 99%

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Robot Assisted Radical Prostatectomy in Kidney Transplant Recipients. Our Clinical Experience and a Systematic Review

et al. 2016

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Introduction: Radical prostatectomy is a more skillful procedure in kidney graft recipients. Robotic surgery can provide a useful minimally invasive tool. Objectives: The study aims to evaluate the robotic-assisted laparoscopic prostatectomy (RALP) in kidney transplant recipients, describing intra/postoperative complications, renal and oncological outcomes. Methods: This is a retrospective study conducted in a single institution of 84 RALP. Four of them were kidney transplant recipients. Side of the renal graft, clinical stage, intra/postoperative events, operating time, creatinine levels before/after intervention and oncologic follow-up were recorded. A systematic review of the literature was performed. Results: Aged 61.25 ± 7.76 years, interval between renal transplantation and RALP: 10 ± 3.16 years. Mean prostate specific antigen: 7.1 ± 2.8 ng/ml, 2 patients were cT1c and 2 cT2a. Preoperative biopsies: Gleason score 3 + 3 in 3 patients, 3 + 4 in 1 patient. Charlson comorbidity index mean was 4.82 ± 0.82. No intra/postoperative events were reported. Mean operating time: 196 ± 20.8 min. Positive surgical margins: 2/4 patients. Pathological analysis: Gleason 3 + 4 in 2 patients and Gleason 3 + 3 in the others 2. A patient developed a bladder neck sclerosis. No differences between pre/postoperative creatinine. Three patients are free of biochemical recurrence and 1 patient required adjuvant radiotherapy. Conclusion: RALP in renal transplant recipients is a safe and feasible technique for localized prostate cancer. No difference in oncological outcomes and no impairments on renal function were found.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Robot Assisted Radical Prostatectomy in Kidney Transplant Recipients. Our Clinical Experience and a Systematic Review

et al. 2016

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“…No significant difference in terms of preoperative characteristics was observed, but the authors nevertheless modified the position of two lateral trocars according to the position of the transplant. 10 The main complications in this series were two rectal injuries and a longer bladder catheterization time (18 ± 15.4 days). No significant difference in terms of oncological results was observed (only 1 case of positive surgical margins without biochemical recurrence).…”

mentioning

confidence: 69%

“…At 6 months, only 1 patient required dialysis due to iliac vein thrombosis with extension into the transplant vein with no history of lymph node dissection. 10 Retropubic radical prostatectomy (RRP), according to the technique described by Walsh, has been studied in renal transplant recipients and has been the subject of several publications, including the multicentre Renal Transplantation Committee of French Urological Association study conducted between 1996 and 2007, which compared retropubic prostatectomy between renal transplant recipients (n = 20) and a control group (n = 40). 4 The main significant difference was an earlier age at diagnosis in the renal transplant population (60.4 vs. 64.4 years).…”

Section: Discussionmentioning

confidence: 99%

Technical feasibility of robot-assisted laparoscopic radical prostatectomy in renal transplant recipients: Results of a series of 12 consecutive cases

Clerc¹,

Lecornet²,

Léon³

et al. 2015

CUAJ

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Introduction: We evaluate the technical feasibility of robotic prostatectomy in renal transplant recipients. Methods: We retrospectively analyzed preoperative and perioperative settings, as well as functional and oncologic results of 12 patients operated on between 2009 and 2013. Prostatectomy was performed via a transperitoneal approach without any changing in the ports position. The average age was 61.92 ± 2.98 years. The period between transplant and the diagnosis of adenocarcinoma was 79.7 months. The mean PSA was 7.34 ng/mL (range: 4.9-11). Results: The operative time was 241.3 ± 35.6 minutes with only one conversion and one transfusion. The intervention was difficult due to adhesions on the side of the graft in 50% of cases. There was a case of obstructive acute renal failure resulting from a hematoma of the Retzius treated by percutaneous nephrostomy at D20. There was a majority of pT2c (72.7%), including 3 positive margins (27.3%) and 2 biochemical relapses treated with radiotherapy and hormonotherapy, respectively. The end point prostate-specific antigen was undetectable. There was no significant difference between preoperative and J7 creatinine (p = 0. 22). Conclusions: Robotic prostatectomy in renal transplant recipients is a safe technique with no serious effects on the allograft. IntroductionFor patients with end-stage renal disease, renal transplantation is the best treatment in terms of patient survival and quality of life.1 However, the need for immunosuppressive therapy following transplantation increases the incidence of certain cancers, 2 including urological cancers. 3 Prostate cancer is the most common urological cancer in male renal transplant recipients, with an incidence of 3.1%. 3The functional and oncological results of radical prostatectomy in these patients remain poorly evaluated. The results of retropubic 4,5 and laparoscopic prostatectomy have been previously reported, 6-8 but few studies have evaluated robot-assisted laparoscopic prostatectomy. 9 We therefore evaluated the technical feasibility and oncological results of robot-assisted laparoscopic radical prostatectomy (RALP) in renal transplant recipients. MethodsThis single-centre retrospective study included 12 renal transplant recipients who underwent RALP between January 2009 and January 2013.Clinicom 2001 version 6.50.0102 (Cliniom, Inc.) was used for data collection and Fusion Pégase 4D version 4.0.0 (Fusion Pégase Inc.) was used for anesthetic data. RALP was performed according to the conventional technique with 6 transperitoneal trocars. Lymph node dissection was not performed on the side of the transplant.Clinical data (age at the time of prostatectomy, etiology of end-stage renal disease, interval between renal transplantation and prostatectomy, side of transplantation, immunosuppressive therapy, American Society of Anesthesiologists [ASA] score, body mass index [BMI], and Charlson comorbidity index) were recorded for each patient.The diagnosis of prostate cancer was established on the basis of digital rectal e...

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The role of localised prostate cancer treatment in renal transplant patients: A systematic review

et al. 2023

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ObjectiveTo systematically review and critically appraise all treatment options for localised prostate cancer in renal transplant candidates and recipients.MethodA systematic review was conducted adhering to PRISMA guidelines. Searches were performed in the Cochrane Library, Embase, Medline, the Transplant Library and Trip database for studies published up to September 2022. Risk of bias was assessed with the Cochrane Risk of Bias in Non‐Randomised Studies of Interventions for non‐randomised studies tool.ResultsA total of 60 studies were identified describing 525 patients. The majority of studies were either retrospective non‐randomised comparative or case series/reports of poor quality. The vast majority of studies were focussed on prostate cancer after renal transplantation. Overall, 410 (78%) patients underwent surgery, 93 (18%) patients underwent radiation therapy or brachytherapy, one patient underwent focal therapy (high‐intensity frequency ultrasound) and 21 patients were placed on active surveillance. The mean age was 61 years old, the mean PSA level at diagnosis was 9.6 ng/mL and the mean follow‐up time was 31 months. The majority of patients had low‐risk disease with 261 patients having Gleason 6 prostate cancer (50%), followed by 220 Gleason 7 patients (42%). All prostate cancer mortality cases were in high‐risk prostate cancer (≥Gleason 8). The cancer‐specific survival results were similar between surgery and radiotherapy at 1 and 3 years.ConclusionLocalised prostate cancer treatment in renal transplant patients should be risk stratified. Surgery and radiation treatment for localised prostate cancer in renal transplant patients appear equally efficacious. Given the limitations of this study, future research should concentrate on developing a multicentre RCT with long‐term registry follow‐up.

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Laparoscopic Radical Prostatectomy in Renal Transplant Recipients

Cited by 35 publications

References 16 publications

Robot Assisted Radical Prostatectomy in Kidney Transplant Recipients. Our Clinical Experience and a Systematic Review

Robot Assisted Radical Prostatectomy in Kidney Transplant Recipients. Our Clinical Experience and a Systematic Review

Technical feasibility of robot-assisted laparoscopic radical prostatectomy in renal transplant recipients: Results of a series of 12 consecutive cases

The role of localised prostate cancer treatment in renal transplant patients: A systematic review

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