ORIGINAL ARTICLE   Free access

Minerva Urologica e Nefrologica 2018 October;70(5):479-85

DOI: 10.23736/S0393-2249.18.03114-4

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Extraperitoneal robot-assisted radical prostatectomy: a high-volume surgical center experience

Marcello SCARCIA, Michele ZAZZARA, Lucia DIVENUTO, Giuseppe CARDO, Filippo PORTOGHESE, Michele ROMANO, Giuseppe M. LUDOVICO ✉

Department of Urology, Ospedale Generale Regionale “F. Miulli,” Acquaviva delle Fonti, Bari, Italy

BACKGROUND: Herein we report our high-volume single center experience with extraperitoneal robot-assisted radical prostatectomy (eRARP) in patients with prostate cancer (PCa).
METHODS: A retrospective chart review of our prospectively maintained institutional PCa database was performed to analyze eRARP cases done between April 2009 and March 2016. Nerve-sparing technique was applied in accordance with Tewari. Baseline characteristics, surgical outcomes, continence and erectile function were assessed by descriptive statistics.
RESULTS: Of 1354 patients, 61% had intermediate-risk disease. Mean total operative duration was 146±44 min (median 140 minutes; interquartile range 120-160 minutes). In 91.7% of case no complication was recorded. Gleason Score on final pathology was mostly 6 (43.3%) or 7 (3+4) (32.3%). The pathological T stage was mostly pT2c (53.8%). Patients who had a bilateral nerve sparing procedure showed the best functional results, with 81.2% continence rate at 1 month, and 65% reported recovery of erectile function at 3 months postoperation.
CONCLUSIONS: eRARP is a safe, reproducible, and effective procedure for the surgical treatment of prostate cancer. Superior functional outcome can be achieved when a bilateral intrafascial nerve-sparing approach can be performed.

KEY WORDS: Prostatic neoplasms - Prostatectomy - Robotics