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• W2605087269 abstract "You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy V1 Apr 2017MP64-08 SYMPTOMATIC LYMPHOCELE FORMATION AFTER EXTRAPERITONEAL VS. TRANSPERITONEAL ROBOT ASSISTED RADICAL PROSTATECTOMY AND BILATERAL PELVIC LYMPHADENECTOMY David Horovitz, Xiang Lu, Changyong Feng, Edward Messing, and Jean Joseph David HorovitzDavid Horovitz More articles by this author , Xiang LuXiang Lu More articles by this author , Changyong FengChangyong Feng More articles by this author , Edward MessingEdward Messing More articles by this author , and Jean JosephJean Joseph More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1981AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With the peritoneum acting as a natural surface for lymphatic reabsorption, many Urologists believe that a transperitoneal approach to robot assisted radical prostatectomy (tRARP) results in a lower incidence of symptomatic lymphocele (SL) formation compared extraperitoneal robot assisted radical prostatectomy (eRARP) when bilateral pelvic lymph node dissection (BPLND) is performed. There remains a paucity of evidence in support of this claim and no group has directly compared the two approaches for this outcome. Herein, we aim to determine if there is a difference in SL formation and characteristics between the two approaches. METHODS A chart review of patients undergoing RARP and BPLND at a single tertiary care academic center from July 1, 2003 to May 31, 2016 was undertaken. Patients who underwent prior pelvic radiotherapy, concomitant inguinal hernia repair, did not undergo BPLND, or had non-adenocarcinoma of the prostate were excluded. The resulting eRARP and tRARP groups were propensity matched for age, BMI, ASA, D'Amico risk classification and total number of lymph nodes (LN) removed. SL was defined as pelvic fluid collections diagnosed by US, CT or MRI, at least 3 cm in maximal diameter, located directly adjacent to the site of the PLND and associated with pelvic pain or pressure, urinary retention, weakness/malaise, high drain output, leg edema/pain/weakness or infection in patients who underwent PLND. RESULTS 3183 RARP procedures were performed during this time period and after exclusions and propensity matching, 662 and 666 patients remained in the tRARP and eRARP groups respectively. No differences were noted between the groups with regards to age, BMI, operating room time, pathological stage, positive margin rate, pathological Gleason score or pathological stage. The eRARP group had higher ASA scores (p=0.0028) and estimated blood loss (EBL, 218.5±152.4 vs. 182.8±218.5, p<0.0001). The tRARP group had higher D'Amico scores (p=0.22), total number of LN removed (7.3±5.49 vs. 5.8±4.18, p<0.0001), rate of positive LN (p=0.001). SL were identified in 19/666 (2.85%) vs. 11/662 (1.69%) but this was not statistically significant. Of these 30 SL, no differences were noted between the groups with regard to initial presentation, laterality, maximal axial area on CT, hospital admission rate, treatment of SL or drain removal time. CONCLUSIONS The clinical characteristics of SL are similar amongst patients treated with eRARP or tRARP and BPLND. A transperitoneal approach was not associated with lower rates of SL when compared to the extraperitoneal approach. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e847 Advertisement Copyright & Permissions© 2017MetricsAuthor Information David Horovitz More articles by this author Xiang Lu More articles by this author Changyong Feng More articles by this author Edward Messing More articles by this author Jean Joseph More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2605087269 title "MP64-08 SYMPTOMATIC LYMPHOCELE FORMATION AFTER EXTRAPERITONEAL VS. TRANSPERITONEAL ROBOT ASSISTED RADICAL PROSTATECTOMY AND BILATERAL PELVIC LYMPHADENECTOMY" @default.
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