|
VOTED AS AMERICA'S TOP UROLOGISTS A Division of Westchester Medical Group
Randomized comparison of extraperitoneal and transperitoneal access for robot-assisted radical prostatectomy. J Endourol. 2007 Oct;21(10):1199-202 Capello SA, Boczko J, Joseph JV Department of Urology, University of Rochester Medical Center, Rochester, New York 14642, USA. PURPOSE: Although extraperitoneal robot-assisted radical prostatectomy (RARP) is gaining popularity, the majority of these procedures are performed transperitoneally. The purpose of this study was to compare the transperitoneal and extraperitoneal approaches for RARP. PATIENTS AND METHODS: We randomized 62 consecutive patients undergoing RARP into two equal groups according to the route of access. The groups were evaluated for age, body mass index (BMI), preoperative serum prostate specific antigen (PSA) concentration, total operating time, estimated blood loss, specimen weight, pathologic Gleason score and stage, intraoperative and postoperative complications, and surgical-margin status. RESULTS: No significant differences were noted the extraperitoneal and transperitoneal groups with respect total operative time (181 v 191 minutes), blood loss (199 v 163 mL), pathologic Gleason score (6.6 v 6.7), specimen weight (53 v 48 g), or positive-margin status (0 v 1 patient). There were no significant differences in age (56 v 59 years) or PSA (7.8 v 6.1 ng/dL). However, the BMI was significantly higher in the extraperitoneal group (29.8 v 26.5 kg/m(2); P < 0.01). The only complication in the study was a urine leak, which occurred in the transperitoneal group and was managed conservatively. CONCLUSIONS: There were no significant differences in operative parameters in the two groups. Choice of access should be based on patient characteristics as well as surgeon preference. Patients who have had abdominal operations are best suited for the extraperitoneal route. Surgeons should be familiar with both approaches in order to provide patients with the best care. PMID: 17949325 [PubMed - indexed for MEDLINE]
Center for Robotics, Laparoscopy, and Advanced Urology Westchester Medical Group 210 Westchester Avenue Department of Urology White Plains, NY 10604 Tel: 914.682.6470 Fax: 914.681.5264 VIEW MAP >>
1 Theall Road Visit Westchester Medical Group's website at www.westchestermed.com 
|