TY  - BOOK
AU  - Hwang, Jonathan J
TI  - Comparative Outcomes of Salvage Retzius-Sparing Versus Standard Robotic Prostatectomy: An International, Multi-Surgeon Series
SN  - 0022-5347
PY  - 2021///
KW  - *Organ Sparing Treatments/ae [Adverse Effects]
KW  - *Postoperative Complications/ep [Epidemiology]
KW  - *Prostatectomy/ae [Adverse Effects]
KW  - *Prostatic Neoplasms/su [Surgery]
KW  - *Robotic Surgical Procedures/ae [Adverse Effects]
KW  - *Salvage Therapy/ae [Adverse Effects]
KW  - *Urinary Incontinence/ep [Epidemiology]
KW  - Aged
KW  - Feasibility Studies
KW  - Humans
KW  - Incontinence Pads/sn [Statistics & Numerical Data]
KW  - Male
KW  - Middle Aged
KW  - Organ Sparing Treatments/mt [Methods]
KW  - Organ Sparing Treatments/sn [Statistics & Numerical Data]
KW  - Postoperative Complications/et [Etiology]
KW  - Postoperative Complications/th [Therapy]
KW  - Prostate/pa [Pathology]
KW  - Prostate/su [Surgery]
KW  - Prostatectomy/mt [Methods]
KW  - Prostatectomy/sn [Statistics & Numerical Data]
KW  - Retrospective Studies
KW  - Risk Assessment/sn [Statistics & Numerical Data]
KW  - Robotic Surgical Procedures/sn [Statistics & Numerical Data]
KW  - Salvage Therapy/mt [Methods]
KW  - Salvage Therapy/sn [Statistics & Numerical Data]
KW  - Time Factors
KW  - Treatment Outcome
KW  - Urinary Incontinence/et [Etiology]
KW  - Urinary Incontinence/th [Therapy]
KW  - MedStar Washington Hospital Center
KW  - Urology
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - CONCLUSION: SRS-RARP is a feasible salvage option with significantly improved urinary function outcomes. This may warrant increased utilization of SRS-RARP to manage men who fail non-surgical primary treatment for prostate cancer; INTRODUCTION: Salvage prostatectomy (SRP) is rare due to the risk of postoperative complications. We compare salvage Retzius-sparing robotic-assisted radical prostatectomy (SRS-RARP) with salvage standard robotic-assisted radical prostatectomy (SS-RARP); MATERIALS AND METHODS: 72 patients across 9 centers were identified (40 SRS-RARP vs. 32 SS-RARP). Demographics, perioperative data, and pathologic and functional outcomes were compared using student's t-test and ANOVA. Cox proportional hazard models and Kaplan-Meier curves were constructed to assess risk of incontinence and time to continence. Linear regression models were constructed to investigate postoperative pad use and console time; RESULTS: Median follow-up was 23 vs. 36 months for SRS-RARP vs. SS-RARP. Console time and EBL favored SRS-RARP. There were no differences in complication rates or oncologic outcomes. SRS-RARP had improved continence (78.4% vs. 43.8%, p <0.001 for 0-1 pad, 54.1% vs. 6.3%, p <0.001 for 0 pad), lower pads per day (0.57 vs. 2.03, p <0.001), and earlier return to continence (median 47 vs. 180 days, p=0.008). SRS-RARP was associated with decreased incontinence defined as >0-1 pad (HR 0.36, 95% CI 0.15-0.89, p=0.028), although not when defined as >0 pad (HR 0.56, 95% CI 0.31-1.01, p=0.053). On adjusted analysis SRS-RARP was associated with decreased pad per day. Lymph node dissection and primary treatment with SBRT were associated with longer console time
UR  - https://dx.doi.org/10.1097/JU.0000000000001939
ER  -