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Management with Santorini's Plexus Should Be Personalized during Prostatectomy.

Jacek Wilamowski1, Mateusz Wojtarowicz2, Jan Adamowicz1

  • 1Department of Urology and Andrology, Collegium Medicum, Nicolaus Copernicus University, 85-089 Bydgoszcz, Poland.

Journal of Personalized Medicine
|May 28, 2022
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Summary

Managing the Dorsal Venosus Complex (DVC) during laparoscopic prostatectomy impacts surgical outcomes. Omitting DVC ligation may reduce positive margins in the apex, with similar functional results at 12 months.

Keywords:
Santorini’s plexusprostate cancerprostatectomy

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Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • The management of the Dorsal Venosus Complex (DVC) during radical prostatectomy remains a debated topic in urological surgery.
  • Optimal surgical techniques aim to minimize blood loss and positive surgical margins while preserving functional outcomes.

Purpose of the Study:

  • To compare the outcomes of laparoscopic prostatectomy with and without Dorsal Venosus Complex (DVC) ligation.
  • To evaluate the impact of DVC management on blood loss, surgical duration, positive margin rates, and functional recovery.

Main Methods:

  • A comparative study of 457 patients undergoing laparoscopic prostatectomy across two high-volume centers.
  • One center routinely performed DVC ligation, while the other omitted this step.
  • Histological and functional outcomes were assessed and compared between the two groups.

Main Results:

  • DVC management significantly influenced intraoperative blood loss and surgical procedure duration.
  • Omitting DVC ligation was associated with a reduced rate of positive surgical margins, particularly in cases of apical tumor localization.
  • Urinary continence and erectile function showed no significant difference between the groups at 12-month follow-up.

Conclusions:

  • The management strategy for the Dorsal Venosus Complex (DVC) affects key surgical parameters in laparoscopic prostatectomy.
  • Omitting DVC ligation may be a beneficial approach for improving oncological control at the apex without compromising functional outcomes.
  • Further research can refine DVC management protocols to optimize patient results.