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[Radical transcoccygeal prostatectomy]

P Rigatti1, F Francesca, L F Da Pozzo

  • 1Divisione di Urologia, Istituto Scientifico Ospedale San Raffaele, Milano.

Chirurgia Italiana
|January 1, 1996
PubMed
Summary
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Radical transcoccygeal prostatectomy shows promising results for prostate cancer treatment, with good continence rates and manageable complications. Further investigation is needed to define its exact role, especially for incidental prostate cancer.

Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Radical prostatectomy is a primary treatment for prostate cancer.
  • Transcoccygeal radical prostatectomy (TRP) offers an alternative surgical approach.
  • Evaluating the outcomes of TRP is crucial for its clinical adoption.

Purpose of the Study:

  • To assess the clinical outcomes and pathological features of patients undergoing TRP.
  • To determine the safety and efficacy of TRP in prostate cancer management.

Main Methods:

  • A prospective, non-randomized study involving 26 patients undergoing TRP.
  • Procedures included laparoscopic or open pelvic lymphadenectomy.
  • Patient selection was based on risk for nodal metastases or incidental prostate carcinoma.

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Main Results:

  • Low intraoperative complication rates (3.8%).
  • Postoperative complications included leakage and fistula in two patients.
  • Positive surgical margin rate was 26.9%; 80.8% achieved urinary continence.
  • Tumor recurrence observed in 15.4% (PSA-only) and 11.5% (local).

Conclusions:

  • TRP is a safe procedure for prostate cancer treatment with acceptable pathological and clinical outcomes.
  • Complications and outcomes are influenced by patient selection criteria.
  • TRP warrants further investigation, particularly for incidental prostate cancer post-TURP or suprapubic prostatectomy.