Application and Efficacy of Pubovesical Complex Preserving Technique During Laparoscopic Radical Prostatectomy
Journal of Surgery
Volume 7, Issue 3, June 2019, Pages: 67-73
Received: Dec. 10, 2018;
Accepted: Dec. 22, 2018;
Published: Jun. 15, 2019
Views 565 Downloads 71
Chen Jiajun, Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
Zhu Zaisheng, Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
Shi Hongqi, Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
Zhou Pengfei, Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
Xu Lizhen, Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
Zhou Yibo, Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
Zhu Yiyi, Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
Urinary incontinence and Erectile function are two hot issues after radical prostatectomy. This study aims to explore the application and curative effect of “pubovesical complex preserving technique for intrafascial laparoscopic radical prostatectomy (PPLRP)”. Methods: This was a retrospective study of 200 patients who underwent laparoscopic radical prostatectomy (LRP) from January 2011 to May 2018. Results: During the study period, we collected 68 patients with PPLRP in group A, 46 patients with conventional intrafascial LRP in group B and 86 patients with interfascial LRP in group C, respectively. Three groups had no difference in terms of Preoperative age, Clinical stage, Prostate-specific antigen (PSA) value, Gleason score at biopsy and Preoperative good potency (IIEF-5 score) (P>0.05). There was no difference between the three groups in terms of operative time, intraoperative blood loss, time of catheter retain, postoperative stay and histologic status. All groups had similar PSM (positive surgical margin, PSM) rate. Continence rates at immediately after catheter removal, 1,3 and 6 months: 68% (46/68),85% (58/68),93% (63/68) and 100% (68/68) in group A; and 63% (29/46),80% (37/46),89% (41/46) and 96% (44/46) in group B; and 22% (19/63),49% (42/63),72% (62/63) and 84% (72/63) in group C. Regarding sexual function: No differences were found in the three groups in potency (IIEF-5 score). Baseline IIEF-score reached 50%,35% and 21% respectively at postoperative 6 months. Biochemical recurrence-free survival at 3 years was 79.3%,76.3% and 76.4% in A, B and C group, respectively. Conclusions: The PVC preserving technique for LRP provides early recovery from incontinence, faster recovery of sexual function preoperative levels. There is no adverse effect on the oncological outcome in the selective prostate cancer. It is an ideal way of nerve-sparing LRP.
Application and Efficacy of Pubovesical Complex Preserving Technique During Laparoscopic Radical Prostatectomy, Journal of Surgery.
Vol. 7, No. 3,
2019, pp. 67-73.
Haga N, Ogawa S, Yabe M, et al. Factors Contributing to early recovery of urinary continence analyzed by pre- and postoperative pelvic anatomical features at robot-assisted laparoscopic radical prostatectomy [J]. J Endourol, 2015, 29: 683-690. DOI: 10. 1089 / end. 2014. 0708.
Laird A, Fowler S, Good DW, et al. Contemporary practice and technique-related outcomes for radical prostatectomy in the UK: a report of national outcomes [J]. BJU Int, 2015, 115: 753-763. DOI: 10. 1111 / bju. 12866.
Al-Mamari SA, Quintens H, Mentine N, et al. RALP: comparison of the oncological and functional outcomes of the intrafascial and the interfascial approaches [J]. Prog Urol, 2015, 25: 54-61. DOI: 10. 1016 / j. purol. 2014. 08. 237.
Zaisheng Zhu, Qiang Fu, Lizhen Xu, et al. Effect of the modified nerve-sparing technique in open antegrade radical prostatectomy for 30 patients with prostate cancer [J]. Cancer Research and Clinic, 2015, 27: 680-686. DOI: 10. 3760 / cma. j. issn. 1006-9801. 2015. 10. 008.
Riikonen J, Kaipia A, Petas A, et al. Initiation of robot-assisted radical prostatectomies in Finland: impact on centralization and quality of care [J]. Scand J Urol, 2016, 53: 149-154. DOI: 10. 3109 / 21681805. 2016. 1142471.
Yanqun Na, Yinghao Sun. Guidelines for the diagnosis and treatment of prostate cancer [M] / / Yanqun Na, Zhangqun Ye, Yinghao Sun, et al. The 2014 edition of Chinese Department of Urology guidelines for disease diagnosis and treatment. Beijing: People's Medical Publishing House, 2014: 61-89.
Papachristos A, Basto M, Te Marvelde L, et al. Laparoscopic versus robotic-assisted radical prostatectomy: an Australian single-surgeon series [J]. ANZ J Surg, 2015, 85: 154-158. DOI: 10. 1111 / ans. 12602.
Tran SN, Wirth GJ, Mayor G, et al. Prospective evaluation of early postoperative male and female sexual function after radical prostatectomy with erectile nerves preservation [J]. Int J Impot
Res, 2015, 27: 69-74. DOI: 10. 1038 / ijir. 2014. 36.  Walz J, Burnett AL, Costello AJ, et al. A critical analysis of the current knowledge of surgical anatomy related to optimization of cancer control and preservation of continence and erection in candidates for radical prostatectomy [J]. Eur Urol, 2010, 57: 179-192. DOI: 10. 1016/ j. eururo. 2009. 11. 009.
Tunc L, Akin Y, Gumustas H, et al. Detailed surgical anatomy of prostate: relationship between urethra and dorsal vein complex with apex [J]. Urol Int, 2016, 96: 260-267. DOI: 10. 1159/000443674.
Lim SK, Kim KH, Shin TY, et al. Retzius-sparing robot-assisted laparoscopic radical prostatectomy: combining the best of retropubic and perineal approaches [J]. BJU Int, 2014, 114: 236-244. DOI:10. 1111 / bju. 12705.
Walz J, Epstein JI, Ganzer R, et al. A critical analysis of the current knowledge of surgical anatomy of the prostate related to optimisation of cancer control and preservation of continence and erection in candidates for radical prostatectomy: an update [J] Eur Urol, 2016, 70: 301-311. DOI: 10. 1016 / j. eururo. 2016. 01. 026.
Papatsoris A, Mandron E. Anrerior suspension of the dorsal vein complex and fixation of the anterior fibromuscular stroma during laparoscopic prostatectomy for facilitating early continence [J]. BJU Int, 2009, 104: 1542-1546. DOI: 10 1111/ j. 1464-410X. 2009. 09009. X.
Takenaka A, Tewari AK, Leung RA, et al. Preservation of the puboprostatic collar and puboperineoplasty for early recovery urinary continence after robotic prostatectomy anatomic basis and preliminary outcomes [J]. Eur Urol, 2007, 51: 433-440. DOI: 10. 1016 / j. eururo. 2006. 07. 007.
Zhenkai Shi, Xu Gao, Haifeng Wang, et al. Effect of robot assisted radical prostatectomy on postoperative urinary continence [J / CD]. Chinese Journal of endourology (electronic version), 2016, 10: 9-12. DOI: 10. 3877 / cma. j. issn. 1674-3653. 2016. 01. 003.
Xinjian Liu, Jianguo Wen, Qingwei Wang, et al. Meta-analysis of bladder neck preservation during radical prostatectomy for postoperative urinary function recovery [J]. Chinese Journal of Urology, 2016, 37: 174-178. DOI: 10. 3760 / cma. j. issn. 1000-6702. 2016. 03. 004.
Alemozaffar M, Sanda M, Yecies D, et al. Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the Health Professionals Follow-up Study [J]. Eur Urol, 2015, 67: 432-438. DOI: 10. 1016 / j. eururo. 2014. 01. 039.
Xun Shangguan, Baijun Dong, Jiayu Pan, et al. Establishment and evaluation of nomogram for predicting biochemical recurrence in patients with locally adverse pathologic features after radical prostatectomy [J]. Chinese Journal of Urology, 2016, 37: 174-178. DOI: 10. 3760 / cma. j. issn. 1000-6702. 2016. 03. 004.
Zhiyuan Shen, Weiqing Qian, Wei Sheng, et al. Comparative study on the efficacy and safety of robot assisted laparoscopic and retropubic radical prostatectomy [J]. Chinese Journal of Urology, 2015, 36: 174-178. DOI: 10. 3760 / cma. j. issn. 1000-6702. 2016. 08.010.
Busch J, Gonzalgo ML, Leva N, et al. Matched comparison of robot-assisted, laparoscopic and open radical prostatectomy regarding pathologic and oncologic outcomes in obese patients [J]. World J Urol, 2015, 33: 397-402 DOI: 10. 1007 / s00345-014-1326-1.
Soares R, Di Benedetto A, Dovey Z, et al. Minimum 5-year follow up of 1138 consecutive laparoscopic radical prostatectomies [J]. BJU Int, 2015, 115: 546-553. DOI: 10.1111/bju.12887.
Fang Guo, Zhao Liu, Xiaodong Xie. Interpretation and discussion of update points for NCCN prostate cancer clinical treatment guideline [J], Chinese Journal of Urology, 2013, 34: 949-951. DOI: 10. 3760 / cma. j. issn 1000-6702. 2013. 12. 020.