Publication:
Robotic radical prostatectomy in 93 cases: outcomes of the first ERUS robotic urology curriculum trained surgeon in Turkey

dc.contributor.coauthorBedir, Fevzi
dc.contributor.coauthorKeske, Murat
dc.contributor.coauthorDemirdöğen, Şaban Oğuz
dc.contributor.coauthorKocatürk, Hüseyin
dc.contributor.coauthorKoç, Erdem
dc.contributor.coauthorAtmaca, Ali Fuat
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorCanda, Abdullah Erdem
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T12:32:23Z
dc.date.issued2019
dc.description.abstractObjective: this study presents the surgical, oncological, and functional outcomes of the first 93 robotic radical prostatectomy (RARP) procedures performed in Erzurum, Turkey. These procedures were performed by a single surgeon who had completed the European Association of Urology Robotic Urology Section (ERUS) RA RP curriculum in an ERUS-certified training center in Ankara. Material and methods: The study present the results of 93 RARP procedures performed by a single surgeon. The surgeon performing the operations completed an ERUS training program structured for RARP by two robotic surgeons holding ERUS training certificates in an ERUS-approved academic robotic surgery training center in Ankara.The RARP cases performed by the surgeon after completion of the training between April 2016 and August 2018 were retrospectively evaluated. Results: the mean patient age was 63.62 +/- 7.04 years, and the mean preoperative serum prostate-specific antigen level was 8.34 +/- 496 ng/mL. Preoperatively, 82 and 4 patients had prostate biopsy Gleason scores of 3+3 and 4+3, respectively. Bilateral neurovascular bundle (NVB) sparing, unilateral NVB-sparing, and non-NVB-sparing surgery were performed in 21, 13, and 59 cases, respectively. The mean prostate weight was 85.34 +/- 47.57 g Posterior rhabdosphincter reconstruction was performed in 60 (64.5%) cases. Mean console time, intraoperative blood loss, duration of hospital stay, and urethral catheter removal time were 170.49 +/- 36.50 min, 100.70 +/- 34.08 cc, 6.84 +/- 2.28 days, and 7.40 +/- 3.11 days, respectively. During the perioperative period (0-30 days), five minor (prolonged drain output, n=3; rectocele, n=1; gout arthritis, n=1) and six major (inguinal hernia, n=1; incisional hernia, n=2; anastomotic urinary leakage, n=2; myocardial infarction, n=1) complications were identified. No complication was detected during postoperative days 31-90. Postoperative pathological stages included pT'2a, pT2b, and pT2c disease in 77 (82.8%), 9 (9.7%), and 7 (7.5%) patients, respectively. The positive surgical margin (SM) rate was 10.7% (n=10), including patients with pT2a (n=6) and pT2c (n=2) diseases. Eleven (11.8%) patients underwent pelvic lymph node (LN) dissection. The mean LN yield was 16.45 +/- 429. The mean length of follow-up was 11.17 +/- 8.01 months. Biochemical recurrence was observed in two patients, one of whom received maximal androgen blockage (MAB), and the other one received pelvic radiotherapy+MAB. All the patients with at least one-year follow-up (n=48, 51.6%) were fully continent (0 pads/day). Of the 40 (43%) patients with no preoperative erectile dysfunction (ED) and with at least three-month follow-up, 18 (45%) had no ED, with or without any additional medication including phosphodiesterase-5 (PDES) inhibitors. Conclusion: RARP is a safe minimally invasive procedure with acceptable morbidity, excellent operative, pathological and oncological outcomes, and satisfactory functional results. The ERUS RARP curriculum provides effective and sufficient training.
dc.description.fulltextYES
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue3
dc.description.openaccessYES
dc.description.publisherscopeNational
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipN/A
dc.description.versionPublisher version
dc.description.volume45
dc.identifier.doi10.5152/tud.2019.24444
dc.identifier.embargoNO
dc.identifier.filenameinventorynoIR01727
dc.identifier.issn2149-3235
dc.identifier.quartileN/A
dc.identifier.scopus2-s2.0-85065248757
dc.identifier.urihttps://doi.org/10.5152/tud.2019.24444
dc.identifier.wos464646600006
dc.keywordsERUS
dc.keywordsOutcomes
dc.keywordsRobotic radical prostatectomy
dc.keywordsTraining
dc.language.isoeng
dc.publisherAves
dc.relation.grantnoNA
dc.relation.ispartofTurkish Journal of Urology
dc.relation.urihttp://cdm21054.contentdm.oclc.org/cdm/ref/collection/IR/id/8333
dc.subjectMedicine
dc.subjectUrology and nephrology
dc.titleRobotic radical prostatectomy in 93 cases: outcomes of the first ERUS robotic urology curriculum trained surgeon in Turkey
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorCanda, Abdullah Erdem
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine
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relation.isOrgUnitOfPublication.latestForDiscoveryd02929e1-2a70-44f0-ae17-7819f587bedd
relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
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