Abstract
With the incidence of robot-assisted radical prostatectomy (RALP) increasing, questions regarding the significance of margin status have arisen. Patients with a history of a prior transurethral resection of the prostate (TURP) may have a higher incidence of positive margins because of the prior surgery. We examined our IRB-approved database to determine whether patients who had undergone a prior TURP had higher rates of positive margins than patients who had no history of TURP. Between July 2003 and March 2007, six urologic surgeons in our medical group (City of Hope medical group) performed RALP on 2,041 patients. Consent to enter the database was obtained from 1,768 patients. Of these, 51 had undergone prior TURP. Patients with a history of TURP before undergoing RALP had positive margin rates of 35.3% (18 of 51) compared with 17.6% (18 of 102) of patients without a history of TURP (P = 0.015). The location of the positive margins was statistically more prevalent at the bladder neck in TURP patients (13.7 vs. 2.0%) than in non-TURP patients (Fisher’s exact P value = 0.004). These two groups were statistically similar with regard to other variables examined including race, BMI, preoperative PSA, Gleason score, and pathologic stage. Patients who underwent RALP following TURP were found to have a higher positive margin rate. The positive margins were more likely to be located at the bladder neck in TURP versus non-TURP patients.
Similar content being viewed by others
References
Ramon J, Rossignol G, Leandri P, Gautier JR (1994) Morbidity of radical retropubic prostatectomy following previous prostate resection. J Surg Oncol 55:14. doi:10.1002/jso.2930550105
Katz R, Borkowski T, Hoznek A, Salomon L, Gettman MT, Abbou CC (2006) Laparoscopic radical prostatectomy in patients following transurethral resection of the prostate. Urol Int 77:216. doi:10.1159/000094812
Bujons Tur A, Montlleo Gonzalez M, Pascual Garcia X, Rosales Bordes A, Caparros Sariol J, Villavicencio Mavrich H (2006) Radical prostatectomy in patients with history of transurethral resection of the prostate. Arch Esp Urol 59:473–478. doi:10.1016/j.juro.2006.07.140
Jaffe J, Stakhovsky O, Cathelineau X, Barret E, Vallancien G, Rozet F (2007) Surgical outcomes for men undergoing laparoscopic radical prostatectomy after transurethral resection of the prostate. J Urol 178:483–487. doi:10.1016/j.juro.2007.03.114
Menon M, Kaul S, Bhandari A, Shrivastava A, Tewari A, Hemal A (2005) Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia sparing techniques. J Urol 174:2291–2296. doi:10.1097/01.ju.0000181825.54480.eb
Guillonneau B, Vallancien G (2000) Laparoscopic radical prostatectomy: the Montsouris technique. J Urol 163:1643–1649. doi:10.1016/S0022-5347(05)67512-X
Ficarra V, Cavalleri S, Novara G, Aragona M, Artibani W (2007) Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol 51:45. doi:10.1016/j.eururo.2006.06.017
Smith JA, Chan RC, Chang SS, Herrell SD, Clark PE, Baumgartner R et al (2007) A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic prostatectomy and open retropubic radical prostatectomy. J Urol 178:2385. doi:10.1016/j.juro.2007.08.008
Leewansangtong S, Taweemonhongsap T (2006) Is laparoscopic radical prostatectomy after transurethral prostatectomy appropriated? J Med Assoc Thai 89:1146
Columbo R, Naspro R, Salonia A, Montorsi F, Raber M, Suardi N et al (2006) Radical prostatectomy after previous prostate surgery: clinical and functional outcomes. J Urol 176:2459. doi:10.1016/j.juro.2006.07.140
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hampton, L., Nelson, R.A., Satterthwaite, R. et al. Patients with prior TURP undergoing robot-assisted laparoscopic radical prostatectomy have higher positive surgical margin rates. J Robotic Surg 2, 213–216 (2008). https://doi.org/10.1007/s11701-008-0121-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11701-008-0121-7