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Pelvic Lymph Node Dissection: A Comparison Among Extraperitoneal Single-port and Transperitoneal Multiport Radical Prostatectomy-A Single-center Experience.
Pettenuzzo, Greta; Ditonno, Francesco; Cannoletta, Donato; Pacini, Matteo; Morgantini, Luca; Sauer, Ruben Calvo; Torres-Anguiano, Juan R; Montorsi, Francesco; Briganti, Alberto; Bartoletti, Riccardo; Veccia, Alessandro; Bertolo, Riccardo; Antonelli, Alessandro; Crivellaro, Simone.
Afiliación
  • Pettenuzzo G; Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
  • Ditonno F; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
  • Cannoletta D; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
  • Pacini M; Department of Urology, Rush University, Chicago, IL, USA.
  • Morgantini L; Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
  • Sauer RC; Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Torres-Anguiano JR; Vita-Salute San Raffaele University, Milan, Italy.
  • Montorsi F; Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
  • Briganti A; Urology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
  • Bartoletti R; Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
  • Veccia A; Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
  • Bertolo R; Department of Urology, University of Illinois at Chicago, Chicago, IL, USA.
  • Antonelli A; Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
  • Crivellaro S; Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
Eur Urol Open Sci ; 67: 69-76, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39229365
ABSTRACT
Background and

objective:

The role of pelvic lymph node dissection (PLND) for prostate cancer is still controversial. This study aims to compare the outcomes of PLND between extraperitoneal single-port (SP eRARP) and transperitoneal multiport (MP tRARP) robotic-assisted radical prostatectomy.

Methods:

This was a retrospective analysis from our single-center database for patients who underwent SP eRARP or MP tRARP with PLND between 2015 and 2023. The primary endpoint was to analyze and compare specific data related to PLND between the two populations by the detection of pN+ patients, the total number of lymph nodes removed, and the number of positive lymph nodes removed. The secondary endpoints included comparing major complications, lymphoceles, and biochemical recurrence between the two cohorts of the study. Key findings and

limitations:

A total of 293 patients were included, with 85 (29%) undergoing SP eRARP and 208 (71%) undergoing MP tRARP. SP eRARP showed significant differences in PLND extension from MP tRARP, while MP tRARP yielded more lymph nodes (p < 0.001). There were no differences in pN+ patient detection (p = 0.7) or the number of positive lymph nodes retrieved (p = 0.6). The rates of major complications (p = 0.6), lymphoceles (p = 0.2), and biochemical recurrence (p = 0.9) were similar between the two groups. Additionally, SP eRARP had shorter operative time (p = 0.045), hospital stay (p < 0.001), and less postoperative pain at discharge (p = 0.03). Limitations include a retrospective, single-center analysis. Conclusions and clinical implications Despite the SP approach in RARP resulting in fewer retrieved lymph nodes, outcomes were comparable with the MP approach regarding the detection of patients with positive lymph nodes and the number of positive nodes. Additionally, the SP approach led to lower pain levels and shorter hospital stays. Patient

summary:

With this study, we demonstrate that pelvic lymph node dissection performed via the extraperitoneal approach during robotic-assisted radical prostatectomy with a single-port system provides comparable outcomes with the standard transperitoneal multiport approach in detecting patients with positive lymph nodes and retrieving positive nodes. In addition, it offers significantly reduced pain levels and shorter hospital stays.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Urol Open Sci Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur Urol Open Sci Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos