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Minerva Urologica e Nefrologica 2018 October;70(5):479-85

DOI: 10.23736/S0393-2249.18.03114-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Extraperitoneal robot-assisted radical prostatectomy: a high-volume surgical center experience

Marcello SCARCIA, Michele ZAZZARA, Lucia DIVENUTO, Giuseppe CARDO, Filippo PORTOGHESE, Michele ROMANO, Giuseppe M. LUDOVICO

Department of Urology, Ospedale Generale Regionale “F. Miulli,” Acquaviva delle Fonti, Bari, Italy



BACKGROUND: Herein we report our high-volume single center experience with extraperitoneal robot-assisted radical prostatectomy (eRARP) in patients with prostate cancer (PCa).
METHODS: A retrospective chart review of our prospectively maintained institutional PCa database was performed to analyze eRARP cases done between April 2009 and March 2016. Nerve-sparing technique was applied in accordance with Tewari. Baseline characteristics, surgical outcomes, continence and erectile function were assessed by descriptive statistics.
RESULTS: Of 1354 patients, 61% had intermediate-risk disease. Mean total operative duration was 146±44 min (median 140 minutes; interquartile range 120-160 minutes). In 91.7% of case no complication was recorded. Gleason Score on final pathology was mostly 6 (43.3%) or 7 (3+4) (32.3%). The pathological T stage was mostly pT2c (53.8%). Patients who had a bilateral nerve sparing procedure showed the best functional results, with 81.2% continence rate at 1 month, and 65% reported recovery of erectile function at 3 months postoperation.
CONCLUSIONS: eRARP is a safe, reproducible, and effective procedure for the surgical treatment of prostate cancer. Superior functional outcome can be achieved when a bilateral intrafascial nerve-sparing approach can be performed.


KEY WORDS: Prostatic neoplasms - Prostatectomy - Robotics

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