Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platform
Abstract Background Consolidative resection or cytoreductive radical prostatectomy (CRP) may benefit men with non-organ confined prostate cancer. We report the safety, feasibility, and outcomes of robot-assisted laparoscopic CRP using a single-port (SP) or multi-port (MP) platform. Methods We review...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-024-01463-2 |
| _version_ | 1797233276294791168 |
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| author | Daniel J. Lama Kyle Thomas Simone L. Vernez Oluwatimilehin Okunowo Clayton S. Lau Bertram E. Yuh |
| author_facet | Daniel J. Lama Kyle Thomas Simone L. Vernez Oluwatimilehin Okunowo Clayton S. Lau Bertram E. Yuh |
| author_sort | Daniel J. Lama |
| collection | DOAJ |
| description | Abstract Background Consolidative resection or cytoreductive radical prostatectomy (CRP) may benefit men with non-organ confined prostate cancer. We report the safety, feasibility, and outcomes of robot-assisted laparoscopic CRP using a single-port (SP) or multi-port (MP) platform. Methods We reviewed consecutive men with clinical node positive or metastatic castrate-sensitive prostate cancer who underwent IRB-approved CRP and extended pelvic lymph node dissection using the da Vinci SP or MP Surgical Systems (Intuitive Surgical, Sunnyvale, CA) from 2015–2022. Perioperative data and Clavien-Dindo 90-day complications were recorded. Results Twenty-four men with a median age of 61 (IQR 56—69) years and prostate-specific antigen of 32.1 (IQR 21.9—62.3) ng/mL were included. Clinical N1, M1, or N1 + M1 disease were detected in 8 (33%), 9 (38%), 7 (29%) patients, respectively. There was no difference in positive margins, 41% vs. 29% (P = 0.67), lymph node yield, 21 (IQR 14–28) vs. 20 (IQR 13.5–21) nodes (P = 0.31), or estimated blood loss, 150 mL (IQR 100–200) vs. 50 mL (IQR 50–125) (P = 0.06), between the MP and SP cohorts, respectively. Hospital length of stay was significantly shorter for the SP group, same-day discharge (IQR 0–0), compared to MP, 1-day (IQR 1–1), P < 0.001. One grade III bowel obstruction and lymphocele occurred in the MP cohort. No major complications occurred in the SP cohort. Conclusion Robot-assisted laparoscopic CRP is safe and feasible for select men with advanced castrate-sensitive prostate cancer. |
| first_indexed | 2024-04-24T16:13:36Z |
| format | Article |
| id | doaj.art-ba9ed34b497d4302a04dd19685325043 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-24T16:13:36Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-ba9ed34b497d4302a04dd196853250432024-03-31T11:36:39ZengBMCBMC Urology1471-24902024-03-012411810.1186/s12894-024-01463-2Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platformDaniel J. Lama0Kyle Thomas1Simone L. Vernez2Oluwatimilehin Okunowo3Clayton S. Lau4Bertram E. Yuh5Division of Urology and Urologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer CenterDivision of Urology and Urologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer CenterDivision of Urology and Urologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer CenterDepartment of Computational and Quantitative Medicine, Division of Biostatistics, Beckman Research Institute of City of HopeDivision of Urology and Urologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer CenterDivision of Urology and Urologic Oncology, Department of Surgery, City of Hope Comprehensive Cancer CenterAbstract Background Consolidative resection or cytoreductive radical prostatectomy (CRP) may benefit men with non-organ confined prostate cancer. We report the safety, feasibility, and outcomes of robot-assisted laparoscopic CRP using a single-port (SP) or multi-port (MP) platform. Methods We reviewed consecutive men with clinical node positive or metastatic castrate-sensitive prostate cancer who underwent IRB-approved CRP and extended pelvic lymph node dissection using the da Vinci SP or MP Surgical Systems (Intuitive Surgical, Sunnyvale, CA) from 2015–2022. Perioperative data and Clavien-Dindo 90-day complications were recorded. Results Twenty-four men with a median age of 61 (IQR 56—69) years and prostate-specific antigen of 32.1 (IQR 21.9—62.3) ng/mL were included. Clinical N1, M1, or N1 + M1 disease were detected in 8 (33%), 9 (38%), 7 (29%) patients, respectively. There was no difference in positive margins, 41% vs. 29% (P = 0.67), lymph node yield, 21 (IQR 14–28) vs. 20 (IQR 13.5–21) nodes (P = 0.31), or estimated blood loss, 150 mL (IQR 100–200) vs. 50 mL (IQR 50–125) (P = 0.06), between the MP and SP cohorts, respectively. Hospital length of stay was significantly shorter for the SP group, same-day discharge (IQR 0–0), compared to MP, 1-day (IQR 1–1), P < 0.001. One grade III bowel obstruction and lymphocele occurred in the MP cohort. No major complications occurred in the SP cohort. Conclusion Robot-assisted laparoscopic CRP is safe and feasible for select men with advanced castrate-sensitive prostate cancer.https://doi.org/10.1186/s12894-024-01463-2CytoreductionProstate cancerProstatectomyProstate-specific antigenRobotic surgical procedures |
| spellingShingle | Daniel J. Lama Kyle Thomas Simone L. Vernez Oluwatimilehin Okunowo Clayton S. Lau Bertram E. Yuh Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platform BMC Urology Cytoreduction Prostate cancer Prostatectomy Prostate-specific antigen Robotic surgical procedures |
| title | Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platform |
| title_full | Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platform |
| title_fullStr | Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platform |
| title_full_unstemmed | Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platform |
| title_short | Minimally invasive cytoreductive radical prostatectomy, exploring the safety and feasibility of a single-port or multi-port robotic platform |
| title_sort | minimally invasive cytoreductive radical prostatectomy exploring the safety and feasibility of a single port or multi port robotic platform |
| topic | Cytoreduction Prostate cancer Prostatectomy Prostate-specific antigen Robotic surgical procedures |
| url | https://doi.org/10.1186/s12894-024-01463-2 |
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