A Centralized Comparison of Radical Perineal and Retropubic Prostatectomy Specimens: Is There a Difference According to the Surgical Approach?

Korman, Howard; Leu, Patrick B.; Huang, Ray R.; Goldstein, Neal S.

doi:10.1016/s0022-5347(05)64558-2

Cited by 34 publications

(12 citation statements)

References 15 publications

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“…Node dissection no longer being obligatory, the perineal approach became a reasonable alternative to the retropubic approach for RP. The main advantages of the perineal approach are urethrovesical anastomosis under visual control, less blood loss (and lower transfusion requirements), and a shorter hospital stay [7,8,12–18]. In addition, Mokulis and Thompson [19] showed that young surgeons learnt the perineal more rapidly than the retropubic approach.…”

Section: Introductionmentioning

confidence: 99%

Open versus laparoscopic radical prostatectomy: Part I

et al. 2004

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Section: Introductionmentioning

confidence: 99%

Open versus laparoscopic radical prostatectomy: Part I

et al. 2004

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“…Korman et al . [12] compared RPP and RRP and found no significant difference in PSMs between the two approaches. Each surgical approach has propensity for different locations of positive margins[13] and might signify the most difficult area during the surgery.…”

Section: Discussionmentioning

confidence: 99%

Case for resurgence of radical perineal prostatecomy in Indian subcontinent

et al. 2012

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Introduction:Radical perineal prostatectomy was the first surgery described for prostatic carcinoma (Young, 1904) but it lost its eminent status after Walsh's description in 1982 of anatomic radical retropubic prostatectomy followed by the enthusiasm in laparoscopy and now robotics. It made resurgence after it was realized in early 1990s that the pelvic lymph node dissection is needed only in selected cases. Last decade witnessed over 80 publications addressing the results and advances in the perineal approach. Strangely, centres from the subcontinent have chosen to ignore this resurgence. We describe our early experience with the technique in 35 patients and present the case for its more widespread usage.Patients and Methods:Thirty five patients of clinically localized carcinoma prostate were operated by perineal route in our institution from December 2006 onwards. All patients had serum prostate specific antigen levels less than 10 ng/ml.Results:Operating time was 2 to 3.5 hours (mean 2.5 hours). Rectal injury occurred in three patients but was closed primarily in all and none required a colostomy. Mean duration of hospital stay was four days. The disease was organ confined in 25(71%). Positive margins were seen in 5(14%) patients. Biochemical recurrence occurred in 17% patients at one year. Seventy six percent patients had achieved continence at one year.Conclusions:As the world is taking note of radical perineal prostatectomy again, with a very small learning curve, minimal invasion and good oncological control urologists from Indian subcontinent should also embrace this procedure in view of the relative limited resources available.

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“…The two groups had comparable clinical stage and Gleason grades. Although, there was no long-term followup, there was no significant difference in the SM+ rate in the retropubic and perineal procedures (16 versus 22%, P = 0.53) [62]. Another report about SM+ rate was also not significantly different between RRP and RPP (18.9 versus 13.9%) [63].…”

Section: Surgical Marginmentioning

confidence: 99%

Contemporary Radical Prostatectomy

Moul

Sun

2011

Prostate Cancer

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Purpose. Patients diagnosed with clinically localized prostate cancer have more surgical treatment options than in the past. This paper focuses on the procedures' oncological or functional outcomes and perioperative morbidities of radical retropubic prostatectomy, radical perineal prostatectomy, and robotic-assisted laparoscopic radical prostatectomy. Materials and Methods. A MEDLINE/PubMed search of the literature on radical prostatectomy and other new management options was performed. Results. Compared to the open procedures, robotic-assisted radical prostatectomy has no confirmed significant difference in most literatures besides less blood loss and blood transfusion. Nerve sparing is a safe means of preserving potency on well-selected patients undergoing radical prostatectomy. Positive surgical margin rates of radical prostatectomy affect the recurrence and survival of prostate cancer. The urinary and sexual function outcomes have been vastly improved. Neoadjuvant treatment only affects the rate of positive surgical margin. Adjuvant therapy can delay and reduce the risk of recurrence and improve the survival of the high risk prostate cancer. Conclusions. For the majority of patients with organ-confined prostate cancer, radical prostatectomy remains a most effective approach. Radical perineal prostatectomy remains a viable approach for patients with morbid obesity, prior pelvic surgery, or prior pelvic radiation. Robot-assisted laparoscopic prostatectomy (RALP) has become popular among surgeons but has not yet become the firmly established standard of care. Long-term data have confirmed the efficacy of radical retropubic prostatectomy with disease control rates and cancer-specific survival rates.

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A Centralized Comparison of Radical Perineal and Retropubic Prostatectomy Specimens: Is There a Difference According to the Surgical Approach?

Cited by 34 publications

References 15 publications

Open versus laparoscopic radical prostatectomy: Part I

Open versus laparoscopic radical prostatectomy: Part I

Case for resurgence of radical perineal prostatecomy in Indian subcontinent

Contemporary Radical Prostatectomy

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