Retzius Space Preservation Technique for Robotic-Assisted Laparoscopic Radical Prostatectomy in a Kidney Transplant Patient: First Case in Thailand and Our First Experience

Jenjitranant, Pocharapong; Sangkum, Premsant; Sirisreetreerux, P; Viseshsindh, Wit; Patcharatrakul, Suthep; Kongcharoensombat, Wisoot

doi:10.1016/j.transproceed.2016.03.035

Cited by 11 publications

(15 citation statements)

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“…Our literature search yielded 11 studies addressing RS-RARP technique: One randomized control trial (RCT), six observational studies, two case reports, one case series and one descriptive study [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] . We observed a lack of consistency among the parameters in the studies.…”

Section: Resultsmentioning

confidence: 99%

Is Retzius-sparing robot-assisted radical prostatectomy associated with better functional and oncological outcomes? Literature review and meta-analysis

Dirie

Pokhrel

Guan

et al. 2019

Asian Journal of Urology

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Objective To evaluate the efficiency, safety and clinical outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) in comparison with the standard RARP. Methods A systematic search from Web of Science, PubMed, EMBase, Cochrane Library and Google Scholar was performed using the terms “Retzius-sparing”, “Bocciardi approach” and “robot-assisted radical prostatectomy”. Video articles and abstract papers for academic conferences were excluded. Meta-analysis of interested outcomes such as positive surgical margins (PSMs) and continence recovery was undertaken. A comprehensive literature review of all studies regarding Retzius-sparing (RS) approach was conducted and summarized. Results From 2010 to 2017, 11 original articles about RS-RARP approach were retrieved. Of that, only four studies comparing the RS-RARP approach to the conventional RARP were comparable for meta-analysis. Faster overall continence recovery within 1 month after the surgery was noted in the RS group (61% vs. 43%; p = 0.004). PSMs of pT2 and pT3 stages were not significantly different between the groups (10.0% vs. 7.4%; p = 0.39 and 13.1% vs. 9.5%, p = 0.56, respectively). Of all the studies, only one reported sexual recovery outcomes after RS treatment in which 40% of the participants achieved sexual intercourse within the first month. Conclusion Though more technically demanding than the conventional RARP, the RS technique is a safe and feasible approach. This meta-analysis and literature review indicates that RS technique, as opposed to the conventional approach, is associated with a faster continence recovery while PSMs were comparable between the two groups. The limitations of observational studies and the small data in our meta-analysis may prevent an ultimate conclusion. Future well-designed RCTs are needed to validate and confirm our findings.

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Section: Resultsmentioning

confidence: 99%

Is Retzius-sparing robot-assisted radical prostatectomy associated with better functional and oncological outcomes? Literature review and meta-analysis

Dirie

Pokhrel

Guan

et al. 2019

Asian Journal of Urology

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“…A suprapubic port instead of the one ipsilateral to the graft has also been described for extraperitoneal LRP . Retzius‐sparing RARP was also suggested to reduce the risk of ureteric damage .…”

Section: Discussionmentioning

confidence: 99%

“…We included 27 studies reporting oncological and/or functional outcomes of PCa treatment in RTRs for a total of 241 patients from 25 cohort studies and nine case reports (Table ). Studies were published between 1991 and 2016 , including patients treated from 1968 .…”

Section: Methodsmentioning

confidence: 99%

“…The mean age of the RTRs ranged from 50 to 73 years, while the mean PSA level at PCa presentation ranged from 4.5 ng/mL to 143.9 ng/mL (Table ).…”

Section: Methodsmentioning

confidence: 99%

“…Data on functional outcomes and complications were available for six and 14 series, respectively, and for all the case reports (Table []). The mean operating time ranged from 92 to 322 min , blood loss (BL) ranged from 50 to 1 466 mL and hospital stay ranged from 1.8 to 11.9 days .…”

Section: Methodsmentioning

confidence: 99%

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Prostate cancer treatment in renal transplant recipients: a systematic review

et al. 2017

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The aim of this review was to summarize the current evidence and to highlight the main issues future research needs to address regarding prostate cancer (PCa) treatment in renal transpant recipients (RTRs). We conducted a search of AMED, Medline and Embase up to 17 November 2016 to investigate oncological and functional outcomes of PCa treatment in RTR. Type and use/protocols of immunosuppression and peri-operative antibiotic drugs were also assessed. The search was implemented manually. Exclusion criteria were absence of full text or absence of information that allowed us to differentiate oncological and/or functional outcomes of each therapeutic approach used. We included 241 patients from 27 retrospective studies published between 1991 and 2016; seven of the studies were case-control and 20 were case series. We also considered nine case reports published between 1999 and 2016. Follow-up ranged from 1 to 120 months. PCa was organ-confined, with Gleason score ≤6 in 75.2% and 60.4% of patients. Surgery was the most frequent treatment used (n = 186), for which cancer-specific (CSS) and overall survival (OS) rates were both 96.8%. Functional outcomes, including continence and erectile function, and complications were less frequently reported and were generally similar to those reported for radical prostatectomy (RP) in non-RTRs. Other treatment methods in the patients included in the review were radiotherapy (RT) ± androgen deprivation therapy (ADT; n = 34; OS 88.2%; CSS 88.2%), ADT alone (n = 14; OS 42.9%; CSS 64.3%), brachytherapy (BT; n = 11; OS and CSS 100%), watchful waiting (n = 4) and active surveillance (n = 1). Overall no treatment-related graft loss occurred. Immunosuppression and antibiotic schemes were poorly reported and inconsistent. Outcomes of PCa treatment in RTRs are encouraging and do not appear to be inferior to those of non-RTR. RP was the most commonly assessed approach, whilst RT, BT and ADT were less frequent. Immunosuppression and antibiotic use were poorly reported and highly variable. High-quality studies are needed because the current level of evidence is low, and our results should therefore be interpreted with caution.

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The role of localised prostate cancer treatment in renal transplant patients: A systematic review

et al. 2023

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ObjectiveTo systematically review and critically appraise all treatment options for localised prostate cancer in renal transplant candidates and recipients.MethodA systematic review was conducted adhering to PRISMA guidelines. Searches were performed in the Cochrane Library, Embase, Medline, the Transplant Library and Trip database for studies published up to September 2022. Risk of bias was assessed with the Cochrane Risk of Bias in Non‐Randomised Studies of Interventions for non‐randomised studies tool.ResultsA total of 60 studies were identified describing 525 patients. The majority of studies were either retrospective non‐randomised comparative or case series/reports of poor quality. The vast majority of studies were focussed on prostate cancer after renal transplantation. Overall, 410 (78%) patients underwent surgery, 93 (18%) patients underwent radiation therapy or brachytherapy, one patient underwent focal therapy (high‐intensity frequency ultrasound) and 21 patients were placed on active surveillance. The mean age was 61 years old, the mean PSA level at diagnosis was 9.6 ng/mL and the mean follow‐up time was 31 months. The majority of patients had low‐risk disease with 261 patients having Gleason 6 prostate cancer (50%), followed by 220 Gleason 7 patients (42%). All prostate cancer mortality cases were in high‐risk prostate cancer (≥Gleason 8). The cancer‐specific survival results were similar between surgery and radiotherapy at 1 and 3 years.ConclusionLocalised prostate cancer treatment in renal transplant patients should be risk stratified. Surgery and radiation treatment for localised prostate cancer in renal transplant patients appear equally efficacious. Given the limitations of this study, future research should concentrate on developing a multicentre RCT with long‐term registry follow‐up.

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Retzius Space Preservation Technique for Robotic-Assisted Laparoscopic Radical Prostatectomy in a Kidney Transplant Patient: First Case in Thailand and Our First Experience

Cited by 11 publications

References 10 publications

Is Retzius-sparing robot-assisted radical prostatectomy associated with better functional and oncological outcomes? Literature review and meta-analysis

Is Retzius-sparing robot-assisted radical prostatectomy associated with better functional and oncological outcomes? Literature review and meta-analysis

Prostate cancer treatment in renal transplant recipients: a systematic review

The role of localised prostate cancer treatment in renal transplant patients: A systematic review

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