Robotic or Open Radical Prostatectomy After Previous Open Surgery In The Pelvic Region

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Journal Title, Volume, Page: 
Korean J Urol. 2015 Feb;56(2):131-137 ,
Year of Publication: 
Mustafa M
Department of Urology, An-Najah National University Hospital, Nablus, Palestine
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus. Palestine
Pettaway CA
Davis JW
MD Anderson Cancer Center, Huston, TX, USA.
Pisters L.
MD Anderson Cancer Center, Huston, TX, USA.
MD Anderson Cancer Center, Huston, TX, USA.
Preferred Abstract (Original): 
Purpose: We sought to evaluate the feasibility and safety of open or robotic radical prostatectomy (RP) after rectum, sigmoid or colon surgery.
Materials 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.
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