Improved Apical Margins with Use of Periurethral Suspension Stitch in Robotic Assisted Radical Prostatectomy

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Author Info

Kevin Keating Matthew Rohloff Thomas J. Maatman

Corresponding Author

Kevin Keating
Department of Urological Surgery, Metro Health: University of Michigan Health, Michigan, USA

A B S T R A C T

Introduction: Robotic surgery has transformed the standard treatment for localized prostate cancer. Oncologic control is at the foremost concern when treating prostate cancer. Previous studies have detailed the use of a periurethral suspension stitch during robotic assisted radical prostatectomy (RARP), but none have demonstrated significant improvement in surgical margins. Objective: The purpose of this study is to illustrate the use of a periurethral suspension stitch during RARP and its impact on apical surgical margin status. Methods: This study retrospectively analysed 97 patients who underwent RARP by a single high-volume robotic surgeon (TJM) between November 2011 and February 2014. The patients were split into two cohorts with one group (Suspended Stitch) having the dorsal venous complex (DVC) ligation stitch suspended while the second group having the DVC ligation stitch unsuspended (Unsuspended Stitch). Results: Positive margins were seen in 39.6% of patients in the Unsuspended Stitch group and 20.4% of patients in the Suspended Stitch group (p=0.04). Patients in the Unsuspended Stitch group had a Gleason score > 7 in 33.3% of cases, where patients in the Suspended Stitch group had a Gleason score > 7 in 57.1% of cases. Conclusion: Localized prostate cancer treatment has significantly changed with RARP. This study provides an additional technique for achieving improved oncologic control.

Article Info

Article Type

Research Article

Publication history

Received: Sat 06, Mar 2021
Accepted: Tue 16, Mar 2021
Published: Fri 09, Apr 2021

Copyright

© 2023 Kevin Keating. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSO.2021.01.04