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Peritoneal Flap in Robot-Assisted Radical Prostatectomy.

Johannes Bründl1, Sebastian Lenart, Gjoko Stojanoski

  • 1Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany; Department of Urology and Andrology, Hospital of St. John of God (Krankenhaus der Barmherzigen Brüder Wien), Vienna, Austria; Department of Urology and Andrology, Paracelsus Medical University Salzburg, Salzburg, Austria; Department of Urology, St. Elisabeth Hospital Straubing, Straubing, Germany; Department of Urology, Vivantes Humboldt Hospital Berlin, Berlin Germany; These two authors are co-first authors.

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Summary

A peritoneal flap does not prevent lymphocele after robot-assisted radical prostatectomy (RARP) with pelvic lymph node dissection (PLND). This randomized trial found no significant difference in lymphocele rates between patients who received a flap and those who did not.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Clinical Trials

Background:

  • Lymphocele is a common complication following pelvic lymph node dissection (PLND) during robot-assisted radical prostatectomy (RARP).
  • Previous data on using a peritoneal flap to prevent lymphocele were retrospective.

Purpose of the Study:

  • To evaluate the efficacy of a peritoneal flap in preventing lymphocele after RARP with PLND.

Main Methods:

  • A randomized, controlled, multi-center trial involving 232 patients undergoing RARP with PLND.
  • Patients were assigned to either receive a peritoneal flap (intervention group) or not (control group).
  • Primary endpoints included symptomatic lymphocele rates during hospitalization and within 90 days post-surgery.

Main Results:

  • No statistically significant difference in symptomatic lymphocele rates between the flap and control groups (9.1% vs. not specified, p=0.820 at 90 days).
  • Lymphocele volume, need for treatment, and complication rates were similar between groups.
  • Postoperative stress urinary incontinence also showed no significant intergroup differences.

Conclusions:

  • A peritoneal flap does not significantly influence the rate of postoperative lymphocele after RARP with PLND.
  • The routine use of a peritoneal flap for lymphocele prevention in this context is not supported by this trial's findings.