Objective: We aimed to investigate the effect of the presence of median lobe (ML) in the learning curve on perioperative, oncologic and functional outcomes.
Material and Methods: We analyzed 38 consecutive patients undergoing RALP in our clinic between July 2017 and October 2019. Patients were operated by the same surgical team on the first learning curve. They were analyzed in two groups according to the pre- sence or absence of a ML determined during RARP. Perioperative, oncologic and functio- nal results were compared between the gro- ups.
Results: Prostatic ML was detected in 10 (26.3%) of the patients included in the study. Prostate specific antigen (PSA), body mass index (BMI), length of hospital stay, periope- rative and postoperative complication rates were similar in both groups (p <0.01). Surgical margin positivity rate was 20% (2/10) in the ML group and 10.7% (3/28) in the ML group. Numerical differences between the groups were not statistically significant (p <0.01). Nevertheless, prostate volume (p = 0.008) and estimated blood loss (TCC) (p = 0.001) were significant in favor of patients with median lobes. Although the mean cantilever time was slightly higher in patients with ML, these nu- merical differences were not statistically signi- ficant (p <0.01). Bladder neck reconstruction rates were 100% (100%) in the ML group and 14% (4/28) in the ML-free group (p = 0.001). Continence rates bet- ween patients with and without ML were at 4 weeks (20% to 35%) after catheter removal, at 12 weeks (70% to 64.2%) and at 24 weeks (90% to 89.2%). ) and no statistically significant difference was ob- served at all times.
Conclusion: Learning curve, we think that RALP can be appli- ed safely and effectively in challenging cases in centers without high surgical experience. When we compared the oncologic, functional and complication rates of patients without ML in our initial series, we obtained results consistent with the literature.
Keyword: Robot-assisted radical prostatectomy, learning cur- ve, median lobe
Abstract
Objective: We aimed to investigate the effect of the presence of median lobe (ML) in the learning curve on perioperative, oncologic and functional outcomes.
Material and Methods: We analyzed 38 consecutive patients undergoing RALP in our clinic between July 2017 and October 2019. Patients were operated by the same surgical team on the first learning curve. They were analyzed in two groups according to the pre- sence or absence of a ML determined during RARP. Perioperative, oncologic and functio- nal results were compared between the gro- ups.
Results: Prostatic ML was detected in 10 (26.3%) of the patients included in the study. Prostate specific antigen (PSA), body mass index (BMI), length of hospital stay, periope- rative and postoperative complication rates were similar in both groups (p <0.01). Surgical margin positivity rate was 20% (2/10) in the ML group and 10.7% (3/28) in the ML group. Numerical differences between the groups were not statistically significant (p <0.01). Nevertheless, prostate volume (p = 0.008) and estimated blood loss (TCC) (p = 0.001) were significant in favor of patients with median lobes. Although the mean cantilever time was slightly higher in patients with ML, these nu- merical differences were not statistically signi- ficant (p <0.01). Bladder neck reconstruction rates were 100% (100%) in the ML group and 14% (4/28) in the ML-free group (p = 0.001). Continence rates bet- ween patients with and without ML were at 4 weeks (20% to 35%) after catheter removal, at 12 weeks (70% to 64.2%) and at 24 weeks (90% to 89.2%). ) and no statistically significant difference was ob- served at all times.
Conclusion: Learning curve, we think that RALP can be appli- ed safely and effectively in challenging cases in centers without high surgical experience. When we compared the oncologic, functional and complication rates of patients without ML in our initial series, we obtained results consistent with the literature.
Keyword: Robot-assisted radical prostatectomy, learning cur- ve, median lobe