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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Radical perineal prostatectomy and simultaneous extended pelvic lymph node dissection via the same incision
Hansjörg Keller1, Joachim Lehmann, Jörn Beier
1Clinic of Urology and Paediatric Urology, Sana Klinikum Hof, Institute of Pathology, Hof, Germany.
European Urology
|November 7, 2006
Summary
Extended bilateral pelvic lymph node dissection (ePLND) during radical perineal prostatectomy (RPP) is feasible and efficient. This approach offers a fast recovery of urinary continence and a low complication rate, resolving a major disadvantage of RPP.
Area of Science:
- Urology
- Surgical Oncology
- Oncologic Surgery
Background:
- Radical perineal prostatectomy (RPP) is a surgical option for prostate cancer.
- Extended bilateral pelvic lymph node dissection (ePLND) is often performed concurrently to assess nodal status.
- Performing ePLND via a separate incision can increase morbidity.
Purpose of the Study:
- To assess the feasibility of performing ePLND in conjunction with RPP through the same incision.
- To evaluate the oncologic and functional outcomes of this combined approach.
Main Methods:
- A prospective trial involving 90 patients with prostate cancer undergoing RPP and ePLND via a single incision.
- Detailed recording of complications, number of lymph nodes removed, and presence of metastasis.
- Assessment of urinary continence and erectile function using validated questionnaires.
Main Results:
- A mean of 19 lymph nodes were removed, with 12 patients (13.3%) having positive nodes.
- No major complications were reported; seven lymphoceles occurred.
- Significant recovery of urinary continence was observed, with 93% of patients being pad-free at 12 months.
Conclusions:
- Combined ePLND and RPP through a single incision is feasible, efficient, and safe.
- This approach facilitates oncologic staging while improving patient outcomes and addressing a key limitation of RPP.
- The technique is associated with rapid return of urinary continence and a low complication profile.
