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Rachel Soon, 31 Aug 2019

More work needs to be done by Asian healthcare stakeholders to reduce disparities in men’s health between regions and the sexes, says an expert.

Retzius-sparing robotic radical prostatectomy yields better outcomes vs anterior method

05 Jan 2018

Compared with the anterior approach to the prostate, Retzius-sparing-robot-assisted radical prostatectomy is faster, allows a shorter catheterization time, and delivers better continence results at 4 weeks, with most patients being pad-free or needing just a single pad a day, a recent study has shown.

Age, body mass index, prostate-specific antigen, biopsy Gleason sum, clinical stage, d’Amico risk profile, blood loss, prostate weight, and postoperative hospital stay were similar across patients in the two groups.

Patients in the Retzium-sparing group had shorter median operating time (200 min; interquartile range [IQR], 155‒266 vs 223 min; IQR, 100‒238; p=0.05) and catheterization (8 days; IQR, 8‒8 vs 14 days; IQR, 14‒14; p<0.0001), of whom many had suprapubic catheters inserted. Retzius-sparing patients also had lower overall complication rate (2.5 vs 8.0 percent; p=0.36).

Patients in the two groups had similar positive surgical margin rates, which decreased with greater experience with the Retzius-sparing technique (for pT2: 16.7 vs 7.7 percent; p=0.65; for pT3: 31.8 vs 14.3 percent; p=0.44). Initial prostate-specific antigen was <0.1 ng/ml in 97.5 and 100 percent, respectively (p=1.00).

In the Retzius-sparing group, zero, one, and two pads per day were needed in 90.0, 7.5, and 2.5 percent of patients at 4 weeks postoperation, as compared with 37.5 (p<0.0001), 32.5 (p=0.01), and 30 percent (p=0.002) of men having conventional surgery.

A total of 40 patients with T2‒T3 prostate cancer underwent Retzius-sparing-robot-assisted radical prostatectomy. The authors compared the results with those from the 40 patients having robot-assisted radical prostatectomy done by the same surgeon immediately prior to the adoption of the Retzius-sparing technique.

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Most Read Articles
Rachel Soon, 31 Aug 2019

More work needs to be done by Asian healthcare stakeholders to reduce disparities in men’s health between regions and the sexes, says an expert.