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Robotic salvage retropubic prostatectomy after radiation/brachytherapy: initial results.
BJU Int. 2008 Jul; 102(1):93-6.BI

Abstract

OBJECTIVE

To report on the initial four patients who had robotic salvage retropubic prostatectomy (SRP) for biochemical recurrence after radiation therapy, and to review the surgical outcome of robotic cystoprostatectomy for bladder cancer in two patients who previously had prostate cancer.

PATIENTS AND METHODS

Since February 2006, four patients had SRP for biochemical failure after radiation and/or brachytherapy. Transrectal biopsy of the prostate confirmed locally recurrent disease and a metastatic evaluation including bone scan and computed tomography of the abdomen and pelvis were negative in all cases. The SRP was done using a six-port transperitoneal approach. An additional two patients had a robotic cystoprostatectomy for bladder cancer, in whom radiation was provided previously for prostate cancer. A retrospective analysis of the immediate and short-term surgical outcome was reviewed.

RESULTS

SRP was completed in all patients with no major complication or conversion to an open approach. The mean operative duration was 125 min, the mean (range) blood loss was 117 (50-250) mL and the mean hospital stay was 2.7 days. Of the four patients undergoing SRP, three had extracapsular extension and the first two had positive margins, while no patients had rectal injuries or significant blood loss. The lymph nodes were negative in all the patients. Three patients were continent within a month while one continued to use two to three pads/day at 3 weeks of follow-up. In the two patients who had cystoprostatectomy there were no major complications or increased surgical difficulty.

CONCLUSIONS

SRP is technically possible and with limited perioperative morbidity. Further studies are warranted to validate the oncological and functional outcomes of SRP after radiation and/or brachytherapy. Moreover, the robotic approach for radical cystoprostatectomy in patients who have had prostate radiation is feasible, with no increase in perioperative morbidity.

Authors+Show Affiliations

Section of Laparoscopic and Robotic Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA. kaoukj@ccf.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

18410443

Citation

Kaouk, Jihad H., et al. "Robotic Salvage Retropubic Prostatectomy After Radiation/brachytherapy: Initial Results." BJU International, vol. 102, no. 1, 2008, pp. 93-6.
Kaouk JH, Hafron J, Goel R, et al. Robotic salvage retropubic prostatectomy after radiation/brachytherapy: initial results. BJU Int. 2008;102(1):93-6.
Kaouk, J. H., Hafron, J., Goel, R., Haber, G. P., & Jones, J. S. (2008). Robotic salvage retropubic prostatectomy after radiation/brachytherapy: initial results. BJU International, 102(1), 93-6. https://doi.org/10.1111/j.1464-410X.2008.07570.x
Kaouk JH, et al. Robotic Salvage Retropubic Prostatectomy After Radiation/brachytherapy: Initial Results. BJU Int. 2008;102(1):93-6. PubMed PMID: 18410443.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robotic salvage retropubic prostatectomy after radiation/brachytherapy: initial results. AU - Kaouk,Jihad H, AU - Hafron,Jason, AU - Goel,Rajk, AU - Haber,George-Pascal, AU - Jones,J Stephen, Y1 - 2008/04/11/ PY - 2008/4/16/pubmed PY - 2008/7/25/medline PY - 2008/4/16/entrez SP - 93 EP - 6 JF - BJU international JO - BJU Int VL - 102 IS - 1 N2 - OBJECTIVE: To report on the initial four patients who had robotic salvage retropubic prostatectomy (SRP) for biochemical recurrence after radiation therapy, and to review the surgical outcome of robotic cystoprostatectomy for bladder cancer in two patients who previously had prostate cancer. PATIENTS AND METHODS: Since February 2006, four patients had SRP for biochemical failure after radiation and/or brachytherapy. Transrectal biopsy of the prostate confirmed locally recurrent disease and a metastatic evaluation including bone scan and computed tomography of the abdomen and pelvis were negative in all cases. The SRP was done using a six-port transperitoneal approach. An additional two patients had a robotic cystoprostatectomy for bladder cancer, in whom radiation was provided previously for prostate cancer. A retrospective analysis of the immediate and short-term surgical outcome was reviewed. RESULTS: SRP was completed in all patients with no major complication or conversion to an open approach. The mean operative duration was 125 min, the mean (range) blood loss was 117 (50-250) mL and the mean hospital stay was 2.7 days. Of the four patients undergoing SRP, three had extracapsular extension and the first two had positive margins, while no patients had rectal injuries or significant blood loss. The lymph nodes were negative in all the patients. Three patients were continent within a month while one continued to use two to three pads/day at 3 weeks of follow-up. In the two patients who had cystoprostatectomy there were no major complications or increased surgical difficulty. CONCLUSIONS: SRP is technically possible and with limited perioperative morbidity. Further studies are warranted to validate the oncological and functional outcomes of SRP after radiation and/or brachytherapy. Moreover, the robotic approach for radical cystoprostatectomy in patients who have had prostate radiation is feasible, with no increase in perioperative morbidity. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/18410443/Robotic_salvage_retropubic_prostatectomy_after_radiation/brachytherapy:_initial_results_ L2 - https://doi.org/10.1111/j.1464-410X.2008.07570.x DB - PRIME DP - Unbound Medicine ER -