SUO 2017: Retzius-sparing Robotic-assisted Laparoscopic Radical Prostatectomy: A Safe Oncologic Surgical Technique With Superior Continence Outcomes

Washington, DC ( Introduction: Conventional robotic-assisted laparoscopic radical prostatectomy (RALRP) is associated with significant side effects, including urinary incontinence. The authors of this study aimed to compare the peri-operative, oncologic, and functional outcomes of prostate cancer patients undergoing a Retzius-sparing RALRP (RS-RALRP) to those undergoing a conventional RALRP.

Methods: This was a prospective, single-center, consecutive case series of 100 and 100 patients undergoing a RS-RALRP and RALRP, respectively, by a single surgeon between March 2015 and April 2017.

Results: Baseline patient characteristics were similar between the two groups. The Retzius-sparing approach required significantly less console time (120.0 vs. 144.0 mins, p<0.001). There were no differences in intra- or post-operative complication rates, and hospital length of stay was similar in the two groups. Patients in the Retzius-sparing group had significantly superior rates of achieving post-operative urinary continence (log-rank test: p<0.001), with 20% of patients continent within the first month, compared to 8% of patients in the conventional group. Mean number of pads per day needed at three, six, nine, and 12 months post-operatively was also significantly lower in the Retzius-sparing group. Incidence of positive surgical margins was similar among both groups. Similarly, there were no differences in rates of biochemical failure at three and six months post-operatively.

Conclusion: The authors conclude that RS-RALRP requires shorter console time, is oncologically safe, and leads to significantly superior continence outcomes compared to conventional RALRP.

Presented by: Rashid Sayyid, Medical College of Georgia, Augusta University, Augusta, GA, USA

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC

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