Post-renal Transplant Retzius Sparing Robotic Radical Prostatectomy: Initial Experience and Case Report
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SURGERY
Post-renal Transplant Retzius Sparing Robotic Radical Prostatectomy: Initial Experience and Case Report Abhishek Laddha 1
&
Ginil Kumar Pooleri 1 & Vishnu Raveendran 2 & Kishore Thekke Adiyat 2
Accepted: 10 September 2020 # Springer Nature Switzerland AG 2020
Abstract Retzius sparing robotic radical prostatectomy is now an accepted alternative to standard RARP. Our paper aims to evaluate the feasibility, complications, and oncological outcomes of the RS-RARP in kidney transplant recipients. We did a retrospective analysis of 3 patients who underwent retzius sparing robotic radical prostatectomy post-renal transplant. Operative, oncological, and functional outcomes are analyzed. A total of 3 patients underwent RS-RARP post-renal transplant. Mean operative time was 143.2 ± 9.06 min, and nerve-sparing was performed on one side in 1 patient. None of the patients had any intraoperative or postoperative events. Final pathological staging was upgraded in all three patients and was pT3aN0Mx. All three patients were fully continent in the immediate postoperative period after catheter removal. All three patients were free of biochemical recurrence with PSA of less than 0.2 in all patients with no need for additional treatment till last follow-up. There was no change in renal function in the immediate postoperative period and 1 month follow-up in any patient. Retzius sparing robotic radical prostatectomy can be performed safely in a post-transplant setting with minimal complications and excellent functional and oncological outcomes. Keywords Prostate cancer . Retzius sparing robotic radical prostatectomy . Renal transplant . Robotics . Radical prostatectomy . Case report
Introduction Genitourinary cancers are the second most common cancer after skin malignancies in renal transplant recipients. Among genitourinary cancers, prostate cancer (CaP) ranks first with an overall incidence of 3.1% [1, 2]. Post-transplant risk of CaP is around 2 times of general population with a more aggressive course [3] and lower cancer-specific survival, which warrants aggressive management [4]. Surgery and radiotherapy are options for management for organ-confined CaP [5–7]. Robotic radical prostatectomy in these patients is considered challenging in view of previous intervention, the position of graft, and immunosuppression use. Robot-assisted laparoscopic radical This article is part of the Topical Collection on Surgery * Abhishek Laddha [email protected] 1
Department of Urology, Amrita Institute of Medical Sciences and Research Center, AIMS Ponekkara, P.0, Kochi, Kerala 682041, India
2
Department of Urology, Aster Medicity Hospital, Kochi, India
prostatectomy (RARP) is described by various surgeons in the post-transplant setting with minimal complications [8–13]. Retzius sparing robotic radical prostatectomy (RS-RARP) is now an accepted alternative to standard RARP. Our paper aims to evaluate the feasibility, complications, and oncological outcomes of the RS-RARP in kidney transplant recipients.
Methods We did a retr
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