Robotic or open radical prostatectomy after previous open surgery in the pelvic region - Abstract

PURPOSE: We sought to evaluate the feasibility and safety of open or robotic radical prostatectomy (RP) after rectum, sigmoid, or colon surgery.

MATERIALS AND METHODS: Sixty-four patients with a median age of 65 years (range, 46-73 years) who underwent RP after previous pelvic surgery were included. Twenty-four patients (38%) underwent robotic RP and 40 patients (62%) underwent open RP. Bilateral lymph node dissection and nerve preservation were performed in 50 patients (78%) and 35 patients (55%), respectively. Variables evaluated included demographic characteristics, perioperative complications, and functional and oncological outcomes. The median hospitalization and follow-up periods were 2 days (range, 1-12 days) and 21 months (range, 1-108 months), respectively.

RESULTS: No conversions from robotic to open surgery were performed and there were no intraoperative complications. Surgical margins were positive in 13 patients (20%), seminal vesicle involvement was detected in 6 patients (9%), and lymph node involvement was found in 2 patients (3%). Postoperative complications included lymphocele in 1 patient, urethral stricture in 1 patient, and bowel obstruction and persistent bladder leakage in 2 patients. Eighty-eight percent of the patients were continent at 7 months and 80% of patients were able to achieve erection with or without medical aid.

CONCLUSIONS: Open or robotic RP can be done safely and effectively in patients who have previously undergone pelvic surgery. Although prior pelvic surgery of the large intestine was associated with increased morbidity, it should not be considered a contraindication for robotic or open RP.

Written by:
Mustafa M, Pettaway CA, Davis JW, Pisters L.   Are you the author?
Department of Urology, An-Najah National University Hospital, Nablus, Palestine; MD Anderson Cancer Center, Huston, TX, USA.

Reference: Korean J Urol. 2015 Feb;56(2):131-7.
doi: 10.4111/kju.2015.56.2.131

PubMed Abstract
PMID: 25685300 Prostate Cancer Section