Propensity-Score Matched Analysis Between Extraperitoneal Single Port and Intraperitoneal Multiport Radical Prostatectomy: A Single-Institutional Experience

Harrison, Robert; Stifelman, Michael; Billah, Mubashir; Zaifman, Jay; Lulla, Tina; Rosa, Ruth Sanchez De La; Koster, Helaine; Lovallo, Gregory; Ahmed, Mutahar

doi:10.1016/j.urology.2022.02.027

Cited by 11 publications

(6 citation statements)

References 29 publications

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“…The time taken to complete the two procedures ranged between 100 – 240 min, with EBL ranging between 50 and 200 mL. One institution reported routine use of an 8 mm assistant port in 38% of their extraperitoneal cohort [ 17 ]. Compared with the transperitoneal cohort, LND was more commonly pursued in 77–94% of patients who underwent extraperitoneal and Retzius-sparing SP-RARP.…”

Section: Resultsmentioning

confidence: 99%

“…There were no intraoperative complications in the Retzius-sparing cohort. Of the four complications reported during the extraperitoneal approach, two were attributed to iatrogenic pneumothorices, which necessitated intraoperative placement of intercostal catheters [ 6 , 17 ]. Similar to transperitoneal SP-RARP, most patients were discharged within 24 h with a relatively low risk of major postoperative complications (0–15%) [ 5 – 8 , 18 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…identified the PSM rates of 26%, 36%, and 40% for pT2, pT3a, and pT3b, respectively [ 7 ]. Nevertheless, the biochemical recurrence rates in most cases remained relatively low, as summarized in Table 1 [ 6 – 8 , 17 , 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…reported full erection in 37% and partial erection in 25% after 12 months, while Lenfant et al . noted varying degrees of erectile function in 80% after 12 months [ 17 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

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Single-port robot-assisted radical prostatectomy

Soputro,

Kaouk

2024

World J Urol

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Purpose To provide a comprehensive update on the different techniques and outcomes of contemporary Single-Port (SP) Robotic Radical Prostatectomy (RARP) approaches. Methods A literature review was performed to identify cohort studies that have utilized the purpose-built SP robotic platform (Intuitive Surgical Inc., Sunnyvale, California) for RARP. All published approaches of SP-RARP were included in our review. Baseline clinical, perioperative, and postoperative oncological and functional outcomes were collected from the included studies. Results A total of 16 studies involving 1159 patients were identified. To date, five approaches of SP-RARP have been described, namely Transperitoneal, Extraperitoneal, Retzius-Sparing, Transperineal, and Transvesical. The surgical steps and clinical outcomes of the aforementioned approaches were discussed. While operating times were still faster in the Transperitoneal and Extraperitoneal cohorts, the novel and more regionalized Transvesical approach allowed for radical prostatectomy to be pursued in more patients with previous abdominal surgeries and contributed to significantly improved postoperative outcomes, including the earlier return of urinary continence and with most patients being discharged on the same day without any opioids. Conclusion Based on the existing literature, the introduction of SP-RARP not only enriched the repertoire of minimally-invasive surgical treatment options for prostate cancer but also provided the opportunity for urologists to develop new techniques that can improve perioperative outcomes and postoperative quality of life. Given the limited number of patients and heterogeneity in the patient selection and reporting of postoperative outcomes, further research remains necessary to better understand the different benefits and improve patient selection algorithms for the different techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…reported full erection in 37% and partial erection in 25% after 12 months, while Lenfant et al . noted varying degrees of erectile function in 80% after 12 months [ 17 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

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Single-port robot-assisted radical prostatectomy

Soputro,

Kaouk

2024

World J Urol

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“…In reality, the comfort of a large working space and improved visibility still make the transperitoneal approach favorable for most urologists ( 30 ). Single-port RARP could be performed in a smaller operating space, which allows it to be performed in extraperitoneal ways more easily ( 31 ). Compared with transperitoneal single-port RARP, extraperitoneal single-port RARP is associated with a significantly shorter postoperative hospital stay and decreased need for postoperative narcotics ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Single-site multiport vs. conventional multiport robot-assisted radical prostatectomy: A propensity score matching comparative study

et al. 2022

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ObjectiveRobot-assisted radical prostatectomy (RARP) is a dynamically evolving technique with its new evolution of single-site RARP. Here we sought to describe our extraperitoneal technique, named the single-site multiport RARP (ssmpRARP) using the da Vinci Si® platform and compare it with the transperitoneal conventional multiport RARP (cmpRARP).Materials and MethodsData were retrospectively collected for patients who underwent RARP for localized prostate cancer from June 2020 to January 2022 in a single center. Propensity score matching was performed based on age, prostate size, body mass index, neoadjuvant hormonal therapy usage, prostate-specific antigen levels, and clinical T stage. The differences between the matched two groups were investigated.ResultsOf the patients, 20 underwent ssmpRARP and 42 underwent cmpRARP during the period. After matching, 18 patients from each group were selected. Median follow-up was 7.8 months (2–12 months) for the ssmpRARP group, and 15.0 months (3–26 months) for cmpRARP. The demographic features between the two groups were comparable. The median total operative time, estimated blood loss, pathologic data, early follow-up outcomes, and hospitalization stays and costs were similar between the two groups. The ssmpRARP group tended to return to their bowel activities earlier (44.78 ± 10.83 h vs. 54.89 ± 12.97 h, p = 0.016). There were no significant differences in complication rates.ConclusionsWe demonstrated the feasibility and safety of performing extraperitoneal ssmpRARP using the da Vinci Si® robotic platform. Our technique showed comparable short-term outcomes with the transperitoneal cmpRARP. Prospective trials and long-term follow-up are necessary to confirm these results.

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Comparing the safety and efficacy of single-port versus multi-port robotic-assisted techniques in urological surgeries: a systematic review and meta-analysis

Ge,

Zeng,

et al. 2024

World J Urol

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Propensity-Score Matched Analysis Between Extraperitoneal Single Port and Intraperitoneal Multiport Radical Prostatectomy: A Single-Institutional Experience

Cited by 11 publications

References 29 publications

Single-port robot-assisted radical prostatectomy

Single-port robot-assisted radical prostatectomy

Single-site multiport vs. conventional multiport robot-assisted radical prostatectomy: A propensity score matching comparative study

Comparing the safety and efficacy of single-port versus multi-port robotic-assisted techniques in urological surgeries: a systematic review and meta-analysis

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