prostatectomy
Robotic or Open Radical Prostatectomy After Previous Open Surgery In The Pelvic Region
Sun, 2015-02-01 11:54 — Mahmoud MustafaMaterials and Methods: Sixty-four patients, median age 65 years (range, 46-73) who underwent RP after prior pelvic surgery were included. Twenty-four (38%) underwent robotic and 40 patients (62%) underwent open RP. Bilateral lymph nodes dissection and nerve preservation were performed in 50 patients (78%) and 35 patients (55%) respectively. Variables evaluated included demographic characteristics, perioperative complications, functional and oncological outcomes. The median hospitalization and follow-up periods were 2 days (range, 1-12) and 21 months (range,1-108 months) respectively.
Results: No conversions from robotic to open surgery were performed and there were no intraoperative complications. Surgical margins were positive in 13 patients (20%), seminal vesicle involvement was detected in 6 patients (9%) and lymph nodes involvement was found in 2 patients (3%). Postoperative complications included; lymphocele in 1 patient, urethral stricture in 1 patient and bowel obstruction and persistent bladder leakage in 2 patients. Eighty eight percentages of patients were continent at 7 months and 80% of patients were able to achieve erection with or without medical aid.
Conclusion: Open or robotic RP can be done safely and effectively in patients who have previously undergone pelvic surgery. Although prior pelvic surgery of the large intestine was associated with increased morbidity, it shouldn't be contraindication for robotic or open RP.
Facebook
Google
LinkedIn
TwitterSalvage Therapies For Radiorecurrent Prostate Cance - Radiorekürren Prostat Kanseri Için Salvage Terapiler
Wed, 2012-01-25 13:13 — Mahmoud MustafaLocally recurrent prostate cancer after radiation therapy, also known as radiorecurrent prostate cancer, has an unfavorable prognosis. Two-thirds of patients with radiorecurrent prostate cancer have an advanced pathological disease status by the time they undergo salvage therapy. Several salvage therapies for radiorecurrent prostate cancer are available. Salvage radical prostatectomy (SRP) and salvage cryoablation are the most feasible and effective therapies for radiorecurrent prostate cancer. Although SRP is technically more difficult and has a higher complication rate than do other salvage therapies, the procedure provides a long-term survival benefit. Preliminary studies of salvage robot-assisted radical prostatectomy (SRARP) suggest that SRARP may be similar to or at least as effective as SRP. The intermediate oncological efficacy and morbidity of salvage cryoablation are similar to those of SRP. Prognostic factors for successful salvage therapy include serum prostate-specific antigen level ≤10 ng/mL, Gleason score ≤8, and a clinical disease stage T1c or T2. Assessing the comparative oncological efficacy and complications of the available salvage therapies for radiorecurrent prostate cancer requires strict guidelines, including universal patient selection criteria and an intergrade definition of biochemical failure.
