Outcomes after robot-assisted laparoscopic radical prostatectomy

Murphy, Declan; Challacombe, Benjamin; Costello, Anthony J.

doi:10.1038/aja.2008.10

Cited by 9 publications

(6 citation statements)

References 53 publications

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“…Drains were removed in all patients before discharge. Catheters were removed after a mean (range) of 6.1 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) days, all with no previous cystogram. Twenty-nine patients had a modified pelvic lymphadenectomy.…”

Section: Resultsmentioning

confidence: 99%

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Laparoscopic radical prostatectomy: oncological and functional results of 126 patients with a minimum 3-year follow-up at a single Chinese institute

Gao¹,

Zhou²,

Li³

et al. 2009

Asian J Androl

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In this study we evaluate the oncological and functional results of the largest cohort of patients in China treated by laparoscopic radical prostatectomy (LRP) and with at least 3 years of follow-up. 126 inconsecutive patients (range 56-78 years, median 62.5) who had an LRP were retrospectively analyzed. The mean prostate specific antigen level and Gleason score was 13.4 ng mL -1 and 6.4, respectively. Twenty-seven patients had unilateral or bilateral nerve preservation and 29 had pelvic lymphadenectomy. Multivariate analysis was used to adjust for differences in clinical and pathological features when comparing the risk for biochemical progression-free survival (bPFS). Urinary continence was assessed by incontinence questionnaire and erectile function by the Sexual Health Inventory for Men score. The mean operative duration was 250 min and blood loss 354 mL. Five patients received blood transfusion and nine had complications, including rectal injury (two), ureteral injury (one), active bleeding (one), bladder neck stenosis (two), paralytic ileus (one), subcutaneous hematoma (one) and port-site hernia (one). The overall positive surgical margin rate was 20.6% and correlated with pathological stage and Gleason score respectively (P = 0.03, P < 0.001 respectively). All patients had ≥ 3 years of follow-up (range 3-6.75 years, mean 4.6, median 4.75). At 3 years of follow-up, the overall survival rate was 100% and the bPFS was 81.0% in all patients; 124 patients (98.4%) were continent; 22 of 27 patients (81.5%) who underwent nerve preservation retained erectile function. Our series confirms that LRP is an effective, safe and precise technique at Chinese institution.

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Section: Resultsmentioning

confidence: 99%

“…The first LRP was performed in 1997 by Schuessler et al [5]. Since then, LRP has been reported widely and it has gained popularity as a PCa treatment [6].…”

mentioning

confidence: 99%

Laparoscopic radical prostatectomy: oncological and functional results of 126 patients with a minimum 3-year follow-up at a single Chinese institute

Gao¹,

Zhou²,

Li³

et al. 2009

Asian J Androl

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“…Currently, there is lack of evidence to support these beliefs. 19 Furthermore, the emerging literature suggests that the more costly RAP may result in more incontinence and impotence and lead men to regret their decision more than men who received ORP. 20,21 Further research is particularly relevant because of soaring treatment costs of new, unproven technologies.…”

Section: Discussionmentioning

confidence: 99%

Men's Perspectives on Selecting Their Prostate Cancer Treatment

Dailey

Eggly

et al. 2011

Journal of the National Medical Association

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Objective In the context of scientific uncertainty, treatment choices for localized prostate cancer vary, but reasons for this variation are unclear. We explored how black and white American men made their treatment decision. Methods Guided by conceptual model, we conducted semistructured interviews of 21 American (14 black and 7 white) men with recently diagnosed localized prostate cancer. Results Physician recommendation was very important in the treatment decision, but patient self-perception/values and attitudes/beliefs about prostate cancer were also influential. Patients who chose surgery believed it offered the best chance of cure and were more concerned that the cancer might spread if not surgically removed. Patients who chose radiation therapy believed it offered equal efficacy of cure but fewer side effects than surgery. Fear of future consequences was the most common reason to reject watchful waiting. Anecdotal experiences of family and friends were also important, especially in deciding “what not to do.” The new technology of robotic-assisted prostatectomy provided optimism for men who wanted surgery but feared morbidity associated with traditional open surgery. Few men seemed aware that treatment did not guarantee improved survival. Conclusion Most men reported making “the best choice for me” by taking into account medical information and personal factors. Perceptions of treatment efficacy and side effects, which derived mainly from physicians’ descriptions and/or anecdotal experiences of family and friends, were the most influential factors in men’s treatment decision. By understanding factors that influence patients’ treatment decisions, clinicians may be more sensitive to individual patients’ preferences/ concerns and provide more patient-centered care.

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“…We expect that with increased training opportunities and adaptation of the technology, greater utilization of the platform, as experienced in urology, may also occur in the field of RALS colorectal surgery [5,32]. Intuitive Surgical has expanded its installed da Vinci Ò base to more than 900 academic and community hospital sites, while sustaining growth in excess of 25% annually.…”

Section: Robotic-assisted Laparoscopic Colorectal Surgerymentioning

confidence: 99%

Designing a robotic colorectal program

Ragupathi¹,

Haas

2011

J Robotic Surg

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Designing a successful robotic colorectal program requires consideration and implementation of several important concepts with continued perseverance through many obstacles that may arise. The ideal strategy is to establish a core group of committed individuals, define the goals and vision of the program, enlist corporate partners, and gain financial support with a sound business, educational, and research plan. Factors such as cost, limited availability, and demanding training are often hindrances to the implementation of a new robotic colorectal program while scheduling conflicts and inadequate resources may present obstacles to developing a colorectal program in institutions with existing robotic surgical programs. In developing a business plan one should consider the potential for increased patient referrals and the benefits of reduced hospital stay, decreased infection and complication rates, and quicker recovery compared with open surgical procedures. The optimal robotics surgical staff will include those most eager to be trained, as they are highly motivated and have the greatest enthusiasm to succeed. The early foundation of accomplishment will be vital to the long-term success of the program. In addition to building the ideal surgical team, patient selection is one of the most crucial considerations in developing a successful robotics program. Initiating a positive impression for robotic-assisted laparoscopic colorectal procedures will be an important precursor to continued success. Likewise, maintaining a regular schedule of procedures may advance the team's competencies and deter complacency. Proper planning, deliberate implementation, and sustained perseverance are key to the successful initiation of a robotic colorectal program.

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Outcomes after robot-assisted laparoscopic radical prostatectomy

Cited by 9 publications

References 53 publications

Laparoscopic radical prostatectomy: oncological and functional results of 126 patients with a minimum 3-year follow-up at a single Chinese institute

Laparoscopic radical prostatectomy: oncological and functional results of 126 patients with a minimum 3-year follow-up at a single Chinese institute

Men's Perspectives on Selecting Their Prostate Cancer Treatment

Designing a robotic colorectal program

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