Scholarlink

Objective <p>To test the impact of fixing a peritoneal flap of the bladder to the plexus Santorini as final step of robot-assisted radical prostatectomy (RARP) to reduce the incidence of symptomatic lymphoceles and postoperative complications.</p> Patients and methods <p>A two-armed prospective randomised, controlled, single-centre trial on 1080 patients with prostate cancer who underwent RARP with bilateral pelvic lymph node dissection was carried out. Patients in the intervention arm received fixation of the peritoneal flap of the bladder to the plexus Santorini at the end of surgery (Michl-technique, MT); in the control group, surgery was performed without this modification. The primary endpoint was the rate of lymphoceles requiring intervention. Secondary endpoints were total lymphocele rate, other complications ≥ grade IIIa according to Clavien-Dindo and continence rates within one year after RARP.</p> Results <p>Overall, between June 2017 and October 2019, 531 patients were randomised to the MT and 549 to the control arm. There were no differences in both arms with respect to age at surgery, PSA, BMI, prostate volume, surgical time, blood loss, and time to removal of the catheter. Overall, in median 14 lymph nodes were dissected and 337 (32%) patients had a lymphocele. There was no statistically significant difference in lymphoceles requiring intervention (7.2% in MT-group versus 8.8% in control group, <i>p</i> = 0.4). There was no difference in continence rates and other complications between the two groups after one-year-follow-up.</p> Conclusions <p>There was no significant reduction in symptomatic lymphoceles observed when using the Michl-technique. Lymphoceles remain a significant complication post lymph node dissection in RARP patients.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of peritoneal bladder flap in robot-assisted radical prostatectomy patients on lymphoceles: a prospective randomised trial

  • 期刊论文

  • 发表日期：

    2025年3月5日

查看全文
  • Randi M. Pose,
  • S. Knipper,
  • B. Beyer,
  • L. Hohenhorst,
  • A. Haese,
  • H. Heinzer,
  • G. Salomon,
  • T. Steuber,
  • L. Budäus,
  • D. Tilki,
  • H. Isbarn,
  • T. Maurer,
  • P. Tennstedt,
  • M. Graefen,
  • U. Michl

摘要

Objective

To test the impact of fixing a peritoneal flap of the bladder to the plexus Santorini as final step of robot-assisted radical prostatectomy (RARP) to reduce the incidence of symptomatic lymphoceles and postoperative complications.

Patients and methods

A two-armed prospective randomised, controlled, single-centre trial on 1080 patients with prostate cancer who underwent RARP with bilateral pelvic lymph node dissection was carried out. Patients in the intervention arm received fixation of the peritoneal flap of the bladder to the plexus Santorini at the end of surgery (Michl-technique, MT); in the control group, surgery was performed without this modification. The primary endpoint was the rate of lymphoceles requiring intervention. Secondary endpoints were total lymphocele rate, other complications ≥ grade IIIa according to Clavien-Dindo and continence rates within one year after RARP.

Results

Overall, between June 2017 and October 2019, 531 patients were randomised to the MT and 549 to the control arm. There were no differences in both arms with respect to age at surgery, PSA, BMI, prostate volume, surgical time, blood loss, and time to removal of the catheter. Overall, in median 14 lymph nodes were dissected and 337 (32%) patients had a lymphocele. There was no statistically significant difference in lymphoceles requiring intervention (7.2% in MT-group versus 8.8% in control group, p = 0.4). There was no difference in continence rates and other complications between the two groups after one-year-follow-up.

Conclusions

There was no significant reduction in symptomatic lymphoceles observed when using the Michl-technique. Lymphoceles remain a significant complication post lymph node dissection in RARP patients.