التفاصيل البيبلوغرافية
| العنوان: |
Single-Port Robotic Radical Prostatectomy Using Transvesical and Transperineal Access in Patients with a Hostile Abdomen. |
| المؤلفون: |
Ferguson EL; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA., Ramos-Carpinteyro R; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA., Soputro N; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA., Chavali JS; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA., Geskin A; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA., Kaouk JH; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA. |
| المصدر: |
Journal of endourology [J Endourol] 2024 Feb; Vol. 38 (2), pp. 150-158. Date of Electronic Publication: 2024 Jan 05. |
| نوع المنشور: |
Journal Article |
| اللغة: |
English |
| بيانات الدورية: |
Publisher: Mary Ann Liebert Country of Publication: United States NLM ID: 8807503 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1557-900X (Electronic) Linking ISSN: 08927790 NLM ISO Abbreviation: J Endourol Subsets: MEDLINE |
| أسماء مطبوعة: |
Original Publication: New York : Mary Ann Liebert, [c1987- |
| مواضيع طبية MeSH: |
Robotic Surgical Procedures* , Prostatic Neoplasms*, Male ; Humans ; Retrospective Studies ; Prostate ; Prostatectomy ; Peritoneum/surgery |
| مستخلص: |
Introduction: Prostate cancer diagnosis and treatment is challenging in surgically complex patients. Radical prostatectomy can be performed without peritoneal entry using novel single-port (SP) transperineal (TP) and transvesical (TV) approaches. We sought to examine the outcomes of radical prostatectomy using novel TP and TV approaches in patients with extensive prior abdominal surgeries. Materials and Methods: From 2019 to 2023, 51 patients with extensive prior abdominal surgeries were identified who underwent TP (18) and SP TV (33) robotic radical prostatectomy. Indications included history of various surgeries with open laparotomy, including J-pouch reconstruction (22, 43%), active stoma (14, 27%), and open bowel resection (9, 18%). In all patients, 12/51 (24%) had a history of incisional hernia repair with mesh. A retrospective analysis was performed. Results: All cases were completed without open conversion, bowel injuries, or blood transfusions. Length of stay was 5.6 hours for TV and 22 hours for TP. No opioids were prescribed in 91% of TV vs 56% of TP. One intraoperative complication (ureteral injury) occurred in a patient undergoing the TP approach. Postoperative complications were noted in 14/51 (27%), including 10/18 (56%) TP vs 4/33 (12%) TV. High-grade complications (Clavien 3) occurred in three patients (6%, all TP). Pathologic staging showed pT3 in 26/51 (17 TV vs 9 TP), while the remainder were pT2. Biochemical recurrences were noted in four patients (8%, three TV and one TP). Immediate continence was noted in 30% of TV patients. Long-term continence after 12 months was 92% in TV and 67% in TP. Conclusions: In patients with extensive prior abdominal surgeries, radical prostatectomy is feasible using a TP or TV approach. No bowel injuries or open conversion were observed. The SP TV approach offers advantages of shorter hospital stay, shorter catheter duration, less opioid use, fewer complications, and improved continence recovery. |
| فهرسة مساهمة: |
Keywords: minimally invasive surgery; radical prostatectomy; transvesical radical prostatectomy |
| تواريخ الأحداث: |
Date Created: 20231209 Date Completed: 20240226 Latest Revision: 20240226 |
| رمز التحديث: |
20240226 |
| DOI: |
10.1089/end.2023.0128 |
| PMID: |
38069569 |
| قاعدة البيانات: |
MEDLINE |
