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Effect of a large prostate gland on open and robotically assisted laparoscopic radical prostatectomy.
BJU Int. 2008 May; 101(9):1140-4.BI

Abstract

OBJECTIVE

To evaluate the outcomes based on gland size between robotically assisted radical prostatectomy (RALP) and open RP (RRP), as larger prostates might increase the difficulty of RP.

PATIENTS AND METHODS

We reviewed 660 patients who had RALP and 340 who had RRP from May 2003 to August 2006; the patients were divided into two groups, with a prostate of >75 and <or=75 g. The clinical characteristics, surgical approach, perioperative and postoperative outcomes were evaluated.

RESULTS

Patients with large prostates were significantly older (P < 0.001), but had a lower pathological stage (RALP, P = 0.046, and RRP, P = 0.008) than patients with small glands, regardless of technique. There was no difference in length of stay or transfusion rates between the groups. A large prostate increased the operative duration of RALP (P < 0.001) but not of RRP. For both RALP and RRP, positive margin rates were lower with larger glands (RALP, P = 0.014; RRP, P = 0.033). Overall, the positive margin rates were lower with RALP (9.9% and 19.0%) than RRP (18.5% and 35.5%) among patients with larger or smaller (P < 0.001) glands, respectively.

CONCLUSIONS

Prostates of >or=75 g had fewer positive margins than smaller glands, regardless of surgical technique. There was also a significant decrease in positive margin rate in among prostates of >75 g in favour of RALP. Thus, RALP appears to be comparable with RRP for patients with large glands, and might reduce the positive margin rate.

Authors+Show Affiliations

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-2765, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

18399829

Citation

Chan, Robert C., et al. "Effect of a Large Prostate Gland On Open and Robotically Assisted Laparoscopic Radical Prostatectomy." BJU International, vol. 101, no. 9, 2008, pp. 1140-4.
Chan RC, Barocas DA, Chang SS, et al. Effect of a large prostate gland on open and robotically assisted laparoscopic radical prostatectomy. BJU Int. 2008;101(9):1140-4.
Chan, R. C., Barocas, D. A., Chang, S. S., Herrell, S. D., Clark, P. E., Baumgartner, R., Smith, J. A., & Cookson, M. S. (2008). Effect of a large prostate gland on open and robotically assisted laparoscopic radical prostatectomy. BJU International, 101(9), 1140-4. https://doi.org/10.1111/j.1464-410X.2007.07428.x
Chan RC, et al. Effect of a Large Prostate Gland On Open and Robotically Assisted Laparoscopic Radical Prostatectomy. BJU Int. 2008;101(9):1140-4. PubMed PMID: 18399829.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of a large prostate gland on open and robotically assisted laparoscopic radical prostatectomy. AU - Chan,Robert C, AU - Barocas,Daniel A, AU - Chang,Sam S, AU - Herrell,S Duke, AU - Clark,Peter E, AU - Baumgartner,Roxy, AU - Smith,Joseph A, AU - Cookson,Michael S, PY - 2008/4/11/pubmed PY - 2008/5/23/medline PY - 2008/4/11/entrez SP - 1140 EP - 4 JF - BJU international JO - BJU Int VL - 101 IS - 9 N2 - OBJECTIVE: To evaluate the outcomes based on gland size between robotically assisted radical prostatectomy (RALP) and open RP (RRP), as larger prostates might increase the difficulty of RP. PATIENTS AND METHODS: We reviewed 660 patients who had RALP and 340 who had RRP from May 2003 to August 2006; the patients were divided into two groups, with a prostate of >75 and <or=75 g. The clinical characteristics, surgical approach, perioperative and postoperative outcomes were evaluated. RESULTS: Patients with large prostates were significantly older (P < 0.001), but had a lower pathological stage (RALP, P = 0.046, and RRP, P = 0.008) than patients with small glands, regardless of technique. There was no difference in length of stay or transfusion rates between the groups. A large prostate increased the operative duration of RALP (P < 0.001) but not of RRP. For both RALP and RRP, positive margin rates were lower with larger glands (RALP, P = 0.014; RRP, P = 0.033). Overall, the positive margin rates were lower with RALP (9.9% and 19.0%) than RRP (18.5% and 35.5%) among patients with larger or smaller (P < 0.001) glands, respectively. CONCLUSIONS: Prostates of >or=75 g had fewer positive margins than smaller glands, regardless of surgical technique. There was also a significant decrease in positive margin rate in among prostates of >75 g in favour of RALP. Thus, RALP appears to be comparable with RRP for patients with large glands, and might reduce the positive margin rate. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/18399829/Effect_of_a_large_prostate_gland_on_open_and_robotically_assisted_laparoscopic_radical_prostatectomy_ L2 - https://doi.org/10.1111/j.1464-410X.2007.07428.x DB - PRIME DP - Unbound Medicine ER -