Comparison of renal function after robot - assisted laparoscopic radical prostatectomy versus retropubic radical prostatectomy

Ergin, Giray; Doluoğlu, Ömer Gökhan; Kirac, Mustafa; Kılınç, Muhammet Fatih; Köprü, Burak; Keseroğlu, Buğra Bilge; Hoşcan, Mustafa Burak

doi:10.1590/s1677-5538.ibju.2018.0103

Cited by 3 publications

(2 citation statements)

References 18 publications

(17 reference statements)

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“…In the RALP procedure, pneumoperitoneum and steep Trendelenburg position decrease renal blood flow and urine output by increasing intra-abdominal pressure (24). Compared with open retropubic radical prostatectomy (RRP), RALP significantly affected the eGFR, urea, and creatinine levels (25). We did not observe the same decreased renal function in our study.…”

Section: Discussioncontrasting

confidence: 64%

Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy on postoperative hepatic and renal function

Lee¹,

Tang²,

Li³

et al. 2020

Gland Surg

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Background: In this retrospective study, we evaluated the effect of two approaches of robotic-assisted laparoscopic radical prostatectomy (RALP). The first approach was pneumoperitoneum via transperitoneal (TP-RALP), and the second approach was extraperitoneal (EP-RALP) on visceral function. We aimed to provide clinical evidence for the perioperative safety with RALP and to help the surgical team choose an appropriate approach for those with hepatic or renal insufficiency.Methods: One hundred and fifty-seven eligible prostate cancer patients from 2015 to 2019 were included in this study. The postoperative related laboratory tests were compared between transperitoneal and extraperitoneal. The primary endpoint was hepatic and renal function. We also evaluate the intraoperative amount of bleeding, the length of postoperative hospital stays, the occurrence of postoperative complications (lymphatic leakage, bleeding, and infection), and the prostate-specific antigen (PSA).Results: Postoperative total bilirubin and bound bilirubin in both groups were significantly increased, while total protein, albumin, globulin, urea, and uric acid were significantly decreased (P<0.05). The total protein, albumin, and globulin are significantly higher in the EP-RALP group than in the TP-RALP group (P<0.05) postoperatively. There are no statistical differences in estimated glomerular filtration rate (eGFR) and creatinine clearance (CCR) between these two groups, postoperatively.Conclusions: RALP had a significant effect on hepatic function after both TP-RALP and EP-RALP approaches, while the latter showed a lesser extent. Our results suggested that pneumoperitoneal pathways have significant effects on protein consumption. Thus, we should require a more cautious choice of surgical approaches when it comes to patients with impaired hepatic function or under risk of hepatic malfunction.

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Section: Discussioncontrasting

confidence: 64%

Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy on postoperative hepatic and renal function

Lee¹,

Tang²,

Li³

et al. 2020

Gland Surg

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“… 23 However, in a more recent study, the incidence of acute renal injury was similar between the two groups, and it was underlined that this issue should be clarified through long-term prospective-randomized trials. 24 Our study did not include the postoperative renal function data of patients, but none of them had any evidence of chronic renal failure in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Comparison of robotic and open radical prostatectomy: Initial experience of a single surgeon

et al. 2020

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Objective: In this study, we aimed to make a comprehensive comparison of the first hundred robot-assisted radical prostatectomy (RARP) and open retropubic radical prostatectomy (RRP) cases of a single surgeon in a high-volume center. Methods: Preoperative, perioperative and postoperative data were collected retrospectively. Perioperative, oncological data and functional results in the first year were compared between the two groups. There were 204 RARPs between January 1, 2014 and December 31, 2019, and 755 RRPs between April 1, 2007 and December 31, 2019. Results: While the operation time was in favor of the open group (117 vs 188 min, p<0.001), the estimated blood loss (328 vs 150 ml, p<0.001), blood transfusion rate (12 vs 2, p=0.021), and re-operation rate (6 vs 0, p=0.001) were in favor of the robotic group. Mean length of hospital stay (5.4 vs 3.1, p<0.001), urine leak rate (11 vs 2, p=0.033), complication rate (37 vs 16, p=0.018), and the 12th month continence rate (67 vs 85, p=0.002) were better in the robotic group. Conclusions: RARP may provide better perioperative outcomes and lower complication rates after the surgeon factor is eliminated in the early period. Since our case group includes the initial 100 patients, studies with larger patient groups with longer follow-up are needed to adapt these early results to general outcomes.\ doi: https://doi.org/10.12669/pjms.37.1.2719 How to cite this:Simsir A, Kizilay F, Aliyev B, Kalemci S. Comparison of robotic and open radical prostatectomy: Initial experience of a single surgeon. Pak J Med Sci. 2021;37(1):167-174. doi: https://doi.org/10.12669/pjms.37.1.2719 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Age and Body Mass Index: the most important factors of urinary and erectile function recovery after robotic assisted radical prostatectomy

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2019

Int. braz j urol.

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and as usual the editor´s comment highlights some papers. We decided to comment the paper about a very interesting topic: Robotic-Assisted Radical Prostatectomy (RARP).Doctor Neumaier and collegues from the FMUSP, Brazil performed on page 703 (1) an interesting study about the factors involved in urinary continence and sexual potency recovery after robotic-assisted radical prostatectomy (RARP). They studied 104 patients operated by two surgeons between 2008 and 2015, with a minimum 12 months follow-up. The patient features (age, body mass index, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and follow-up data (time to reach urinary continence and sexual potency) were collected at 1, 3, 6 and 12 month and every 6 months thereafter. Until the end of the study, only one patient was incontinent and 20.7% were impotent. The authors concluded that the age was a predictor of urinary and erectile function recovery in 12 months and the body mass index was significant factor for potency recovery.With the introduction of robotic surgery, some technical difficulties in laparoscopic surgery were lessened, due to, among other factors, the three-dimensional field of vision, hand tremor filtration and greater ergonomic freedom of movement of the surgeon (2-7). RARP in comparison with the open radical prostatectomy is associated with smaller positive surgical margins for pT2 tumors and better sexual function results during 12 months, and less impairment of urinary function during 12 months (8).Retrospective studies indicate that urinary control rates are better in younger patients, although there is conflicting data in the literature (9)(10)(11)(12). This can be explained by the degeneration of the rhabdosphincter, which occurs with age. In this paper the authors had 16 patients with body mass index (BMI) ≥ 30 kg/m2 at the time of surgery and there was no statistical difference in recovery of urinary continence compared to patients with BMI < 30 kg/m2, but the average time to reach urinary continence was almost double for obese patients. The present paper also confirms that the age in an important factor to impotence recovery. We congratulate the authors for this very important contribution.Age and Body Mass Index: the most important factors of urinary and erectile function recovery after robotic assisted radical prostatectomy

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Comparison of renal function after robot - assisted laparoscopic radical prostatectomy versus retropubic radical prostatectomy

Cited by 3 publications

References 18 publications

Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy on postoperative hepatic and renal function

Transperitoneal versus extraperitoneal robot-assisted laparoscopic radical prostatectomy on postoperative hepatic and renal function

Comparison of robotic and open radical prostatectomy: Initial experience of a single surgeon

Age and Body Mass Index: the most important factors of urinary and erectile function recovery after robotic assisted radical prostatectomy

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