#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Robotic-assisted radical prostatectomy – results of 1500 surgeries


Authors: J. Kočárek 1,2;  J. Heráček 1,2;  M. Čermák 1;  F. Chmelík 1;  M. Matějková 1
Authors place of work: Urologické oddělení, Ústřední vojenská nemocnice - Vojenská fakultní nemocnice Praha primář: MUDr. J. Kočárek, Ph. D. 1;  Urologická klinika, 1. LF Univerzity Karlovy v Praze přednosta: prof. MUDr. T. Hanuš, DrSc. 2
Published in the journal: Rozhl. Chir., 2017, roč. 96, č. 2, s. 75-81.
Category: Původní práce

Summary

Introduction:
Prostate cancer is the most common malignant disease in men. The number of cases of prostate cancer has increased dramatically in recent 20 years. Radical prostatectomy is a surgical method for the first-line treatment of localised prostate cancer. We performed the first robotic-assisted radical prostatectomy on December 16th, 2005, achieved the boundary of 1000 robotic-assisted radical prostatectomies in 2012, and in 2015, we successfully completed the 1500th robotic-assisted operation on the prostate.

Method:
We retrospectively evaluated the oncological and functional results in 1,500 consecutive patients who underwent robotic-assisted radical prostatectomy at our institution between 2005−2015. The robotic system da Vinci Standard was used for the operations until November 2013, and subsequently the robotic system da Vinci Si HD. Mean age of the patients was 63.7 years (40 to 86); mean BMI was 27.7 (19.4 to 41.4); and mean preoperative PSA was 6.7 ng/ml (0.4 to 112.0).

Results:
Pathological stage of the localised prostate cancer was found in 1125 (75%) men, and the stage of locally advanced cancer was found in 363 (24.2%) patients. We determined the Gleason score ≥ 7 in surgical specimens of 1150 (76.7%) men. 171 (11.4%) men underwent pelvic lymphadenectomy; metastases in the pelvic lymph nodes were detected in 36 (21.1%) patients. Urinary continence in the period of up to 1 year after the surgery was evaluated in 1218 (81.2%) patients in the group. 1119 (91.9%) men needed no incontinence pads or one safety pad one year from the surgery. Postoperative erectile function was evaluated in 447 (29.8%) men. One year from the surgery, 247 (55.3%) men were capable of a sufficient erection for sexual intercourse without any supportive therapy. Intraoperative complications according to the Clavien-Dindo classification were observed in 20 (1.3%) patients; complications within 3 months from the surgery were observed in 127 (8.5%) patients.

Conclusion:
Robotic-assisted radical prostatectomy is a clearly defined, safe and reproducible minimally invasive treatment of localised prostate cancer.

Key words:
prostate cancer − robotic surgery − radical prostatectomy − complications


Zdroje

1. Uroweb.cz

2. Kočárek J, Belej K, Chmelík F, et al. Nervy šetřící roboticky asistovaná antegrádní radikální prostatektomie se šetřením prostatické fascie (Afroditina závoje). Ces Urol 2014;18(Suppl 1):58.

3. Dindo D, Demartines N, Clavien PA. Classification of surgical complications. Ann Surg 2004;240:205−13.

4. Clavien PA, Barkun J, Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five year experience. Ann Surg 2009;250:187−96.

5. Reiner WG, Walsh PC. An anatomical approach to the surgical management of the dorsal vein and Santorini´s plexus during radical retropubic surgery. J Urol. 1979;121:198−200.

6. Schuessler WW, Schulman PG, Clayman RV, et al. Laparoscopic radical prostatectomy: initial short-term experience. Urology 1997;50:854−7.

7. Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: initial experience and preliminary assessment after 65 operations. Prostate 1999;39:71−5.

8. Abbou CC, Salomon L, Hoznek A, et al. Laparoscopic radical prostatectomy: preliminary results. Urology 2000;55:630−4.

9. Abbou CC, Hoznek A, Salomon L, et al. Remote laparoscopic radical prostatectomy carried out with a robot. Report of a case. Prog Urol 2000;10:520−3.

10. Feicke A, Baumgartner M, Talimi S, et al. Robotic-assisted laparoscopic extended pelvic lymph node dissection for prostate cancer: surgical technique and experience with the first 99 cases. Eur Urol 2009; 55:876−84.

11. Ham WS, Park SY, Rha KH, et al. Robotic radical prostatectomy for patients with locally advanced prostate cancer is feasible: results of a single-institution study. J Laparoendosc Adv Surg Tech A 2009;19:329−32.

12. Menon M, Shrivastava A, Bhandari M, et al. Vattikuti Institute prostatectomy: technical modifications in 2009. Eur Urol 2009;56:89−96.

13. Ficarra V, Novara G, Rosen R, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012;62:405−17.

14. Novara G, Ficarra V, D’Elia C, et al. Evaluating urinary continence and preoperative predictors of urinary continence after robot assisted laparoscopic radical prostatectomy. J Urol 2010;184:1028−33.

15. Shikanov S, Desai V, Razmaria A, et al. Robotic radical prostatectomy for elderly patients: probability of achieving continence and potency 1 year after surgery. J Urol 2010;183:1803−7.

16. Link BA, Nelson R, Josephson DY, et al. The impact of prostate gland weight in robot assisted laparoscopic radical prostatectomy. J Urol 2008;180:928−32.

17. Skolarus TA, Hedgepeth RC, Zhang Y, et al. Does robotic technology mitigate the challenges of large prostate size? Urology 2010;76:1117−21.

18. Boczko J, Erturk E, Golijanin D, et al. Impact of prostate size in robot-assisted radical prostatectomy. J Endourol 2007;21:184−8.

19. Ficarra V, Novara G, Ahlering T, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol 2012;62:418−30.

20. Wiltz AL, Shikanov S, Eggener SE, et al. Robotic radical prostatectomy in overweight and obese patients: oncological and validated functional outcomes. Urology 2009;73:316−22.

21. Menon M, Tewari A, Peabody JO, et al. Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin North Am 2004;31:701−7.

22. Menon M, Kraul S, Bhandari A, et al. Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia sparing techniques. J Urol 2005;174:2291−6.

23. Broul M, Štrbavý M, Skála P. Hodnocení erektilní dysfunkce po roboticky asistované radikální prostatektomii. Ces Urol 2014;18:324–33.

24. Agarwal PK, Sammon J, Bhandari A, et al. Safety profile of robot assisted radical prostatectomy: a standardized report of complications in 3317 patients. Eur Urol 2011;59:684−98.

25. Novara G, Ficarra V, Rosen R, et al. Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol 2012;62:431−52.

26. Kowalczyk KJ, Levy JM, Caplan CF, et al. Temporal national trends of minimally invasive and retropubic radical prostatectomy outcomes from 2003 to 2007: results from the 100% Medicare sample. Eur Urol 2012;61:803−9.

27. Trinh Q-D, Sammon J, Sun M, et al. Perioperative outcomes of robot assisted radical prostatectomy compared with open radical prostatectomy: results from the Nationwide Inpatient Sample. Eur Urol 2012;61:679−85.

28. Schmitges J, Trinh Q-D, Abdollah F, et al. A population-based analysis of temporal perioperative complication rates after minimally invasive radical prostatectomy. Eur Urol 2011; 60: 564−71.

29. Doležel J, Tvarůžek J, Staník M, et al. Časné zkušenosti s roboticky asistovanou laparoskopickou radikální prostatektomií - prvních 153 pacientů. Ces Urol 2009;13:168–77.

30. Haglind E, Carlsson S, Stranne J, et al. Urinary incontinence and erectile dysfunction after robotic versus open radical prostatectomy: a prospective, controlled, nonrandomised trial. Eur Urol 2015;68:216−25.

31. Diaz M, Peabody JO, Kapoor V, et al. Oncologic outcomes at 10 years following robotic radical prostatectomy. Eur Urol 2015;67:1168−76.

32. Abdollah F, Sood A, Sammona JD, et al. Long-term cancer control outcomes in patients with clinically high-risk prostate cancer treated with robot-assisted radical prostatectomy: results from a multi-institutional study of 1100 patients. Eur Urol 2015;68:497−505.

Štítky
Chirurgie všeobecná Ortopedie Urgentní medicína

Článek vyšel v časopise

Rozhledy v chirurgii

Číslo 2

2017 Číslo 2
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

plice
INSIGHTS from European Respiratory Congress
nový kurz

Současné pohledy na riziko v parodontologii
Autoři: MUDr. Ladislav Korábek, CSc., MBA

Svět praktické medicíny 3/2024 (znalostní test z časopisu)

Kardiologické projevy hypereozinofilií
Autoři: prof. MUDr. Petr Němec, Ph.D.

Střevní příprava před kolonoskopií
Autoři: MUDr. Klára Kmochová, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#