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Progres En Urologie : Journal de... Feb 2004
Comparative Study Review
Topics: Humans; Laparoscopy; Male; Prostatectomy
PubMed: 15098774
DOI: No ID Found -
British Medical Journal Apr 1980
Topics: Aged; Emergencies; Humans; Male; Prostatectomy; Scotland
PubMed: 7388433
DOI: 10.1136/bmj.280.6222.1119-d -
British Medical Journal Mar 1980
Topics: Education, Medical, Graduate; Humans; Male; Prostatectomy; United Kingdom; Urology
PubMed: 7370654
DOI: No ID Found -
Asia-Pacific Journal of Clinical... Apr 2020To describe national surgical patterns of prostate cancer (PCa) care considering radical prostatectomy with or without pelvic lymphadenectomy and consideration of...
AIM
To describe national surgical patterns of prostate cancer (PCa) care considering radical prostatectomy with or without pelvic lymphadenectomy and consideration of robotic-assisted techniques.
METHODS
Retrospective analysis of publicly accessible Medicare claims data was performed for the period 2001-2016 and included patients undergoing radical prostatectomy with or without pelvic lymphadenectomy relative to total and PCa-specific populations among men aged 45-84 years. Proportion of cases performed robotically was considered.
RESULTS
Total procedures performed increased from 2001, peaked in 2009 and subsequently decreased until 2016. Since 2009, the age-specific rate of surgery in men aged 75-84 increased by 2.3-fold, whereas the rates for men aged 55-64 and 45-54 reduced by 44% and 55%, respectively. Rates of concurrent pelvic lymphadenectomy fell until 2009 with subsequent stabilization (ratio 1.05-1.14) through to 2016. Significant regional practice patterns were observed, as was an increasing trend toward a robotic-assisted laparoscopic approach, comprising more than 80% of radical prostatectomies in 2016.
CONCLUSION
Since the peak in 2009, radical prostatectomy is performed less in men <65 years and more in men ≥65 years. An increasing proportion of cases omit concurrent pelvic lymphadenectomy and are performed robotically.
Topics: Aged; Aged, 80 and over; Humans; Lymph Node Excision; Male; Middle Aged; Prostatectomy; Retrospective Studies; Robotics; Time Factors; United States
PubMed: 31056859
DOI: 10.1111/ajco.13158 -
Current Opinion in Urology May 2001The aim of the present review is to compare the advantages and the disadvantages of radical perineal, retropubic and laparoscopic prostatectomy with a close look at the... (Comparative Study)
Comparative Study Review
The aim of the present review is to compare the advantages and the disadvantages of radical perineal, retropubic and laparoscopic prostatectomy with a close look at the laparoscopic procedure, an operation which has gained much attention in the urological world over the last 3 years. Also reviewed are the motivations, in terms of real advantages for the patient and the needs of the urological 'market', that push the urologist towards using the laparoscopic technique instead of the radical retropubic or radical perineal prostatectomy.
Topics: Humans; Laparoscopy; Male; Prostatectomy
PubMed: 11371785
DOI: 10.1097/00042307-200105000-00011 -
Archivos Espanoles de Urologia Jun 2018To analyze the implantation of laparoscopic radical prostatectomy (LRP) in the Public Health System in the Autonomous Community of Madrid (CAM) and to investigate the... (Comparative Study)
Comparative Study
OBJECTIVES
To analyze the implantation of laparoscopic radical prostatectomy (LRP) in the Public Health System in the Autonomous Community of Madrid (CAM) and to investigate the different results between laparoscopic and open radical prostatectomy.
METHODS
We performed a retrospective analysis over a database containing data from 25 hospitals in CAM. We chose 8225 patients treated by radical prostatectomy (open or laparoscopic). Data were collected using a questionnaire including hospital, length of stay, readmissions and mortality. Values are shown in number, percentage and rank. Statistical significance is shown with p<0.05.
RESULTS
Increase of LRP is shown in the period of study, representing only a 11.9% of the radical prostatectomies in 2004 and reaching 56.8% in 2012. There were no significant statistical differences in age, severity or readmissions when stratified by hospital or by technique. We found a 1.05 days increase in length of stay in long-standing hospitals compared to newer hospitals. We also found a decrease in length of stay in LRP group compared to open retropubic prostatectomy (ORP): 4.84 days vs 6.79 days, (p<0.001).
CONCLUSIONS
RP is consolidated as a therapy in CAM. LRP has been successfully implemented in CAM, offering advantage over ORP in terms of hospital stay. We observed statistically significant difference in length of stay in advantage of recent hospitals regarding longstanding.
Topics: Adult; Aged; Aged, 80 and over; Humans; Laparoscopy; Male; Middle Aged; Prostatectomy; Prostatic Neoplasms; Retrospective Studies; Spain; Urban Health
PubMed: 29889036
DOI: No ID Found -
Techniques in Urology 1995Laser prostatectomy has generated considerable interest amongst urologists as an alternative to traditional transurethral resection for the treatment of benign prostatic...
Laser prostatectomy has generated considerable interest amongst urologists as an alternative to traditional transurethral resection for the treatment of benign prostatic hypertrophy. The majority of reports available concerning laser prostatectomy have described use of the neodymium: YAG wavelength delivered via contact or non contact fibers. Recently, a new laser wavelength has become available for urologic use. The holmium: YAG laser is a multipurpose device with many potential applications in urology as well as other surgical disciplines. At a wavelength of 2,100 nm, this laser possesses both ablative and hemostatic properties. Energy and frequency settings can be varied by the operator. Using the holmium: YAG laser as well as the neodymium: YAG laser in a combined procedure, we performed laser prostatectomies in 16 patients. In our series we used the holmium laser to vaporize a channel prior to producing quadrant irradiations with the Nd:YAG laser. At 3-month follow-up there was a mean reduction of AUA symptom scores from 19 to 9 and a mean improvement in peak flows from 13.9 to 16.6 ml/s. Early results show clinical effect but the optimal technique of combined holmium: YAG, Nd:YAG laser prostatectomy is yet to be determined.
Topics: Aluminum Silicates; Ambulatory Surgical Procedures; Follow-Up Studies; Hemostasis, Surgical; Holmium; Humans; Laser Coagulation; Laser Therapy; Male; Neodymium; Prostatectomy; Prostatic Hyperplasia; Treatment Outcome; Urination; Yttrium
PubMed: 9118394
DOI: No ID Found -
Urologic Oncology Jun 2016To determine how robotic prostatectomy affects practice patterns of urologists, we examined the case volume characteristics among certifying urologists for the surgical...
INTRODUCTION AND OBJECTIVES
To determine how robotic prostatectomy affects practice patterns of urologists, we examined the case volume characteristics among certifying urologists for the surgical treatment of prostate cancer. We hypothesized that the utilization of open and robotic prostatectomy as well as lymph node dissection changed dynamically over the last 10 years.
METHODS
A total of 6-month case log data of certifying urologists from 2003 to 2013 were obtained for the American Board of Urology. Cases were identified using Current Procedural Terminology codes for open radical prostatectomy (ORP) and laparoscopic or robotic-assisted laparoscopic prostatectomy (RALP) with a corresponding diagnosis of prostate cancer as defined by ICD-9 code 185.0.
RESULTS OBTAINED
A total of 6,563 urologists submitted case logs, of which 68% (4,470/6,563) reported performing at least one radical prostatectomy (RP), totaling 46,030 RPs logged. There was a 376% increase in the performance of RALP over the study period with robotic volume increasing from 22% of all RP in 2003 to 85% in 2013. Among surgeons performing ORP, the median number performed was 2; of surgeons who performed RALP, the median number performed was 8 (P<0.001). Overall, 39% of surgeons logging ORP performed 2 or fewer RP, whereas 19% of surgeons who performed RALP performed 2 or less RP (P<0.001). The highest volume robotic surgeons (top 10% surgical volume) performed 41% of all RALP with the highest performing robotic surgeon recording 658 prostatectomies over 6 months. Oncologists represented 4.1% of all surgeons performing RP and performed 15.1% of all RP (P<0.001); general urologists performed the majority of RP (57.8%). When performed open, there was no influence of surgeon specialty on the performance of lymph node dissection (LND); if performed robotically, oncologists were significantly more likely to perform LND compared with general surgeons (47% vs. 25.9%, respectively, P<0.001).
CONCLUSIONS
Robotic prostatectomies are performed 5 times more commonly than open prostatectomy and represent 85% of all RP performed by board-certified urologists in 2013. Compared to RALP, ORP are significantly more likely to be performed by lower volume surgeons. Oncologists perform a higher relative percentage of RPs and are significantly more likely to perform LND if performed robotically when compared with general urologists.
Topics: Humans; International Classification of Diseases; Laparoscopy; Male; Minimally Invasive Surgical Procedures; Practice Patterns, Physicians'; Prostatectomy; Prostatic Neoplasms; Robotic Surgical Procedures; United States; Urologists
PubMed: 26935867
DOI: 10.1016/j.urolonc.2016.01.008 -
International Braz J Urol : Official... 2009The authors assess the morbidity, functional results and oncologic follow-up of a series of laparoscopic radical prostatectomies performed in over a 10-year period.
PURPOSE
The authors assess the morbidity, functional results and oncologic follow-up of a series of laparoscopic radical prostatectomies performed in over a 10-year period.
MATERIALS AND METHODS
The data on 780 laparoscopic radical prostatectomies performed between September 1997 and December 2007 were stored in a personal database. The following parameters are described and critically analyzed: operative time, blood transfusions, conversions, length of hospital stay, complications, functional results of sexual potency and urinary continence, surgical margins and oncologic follow-up.
RESULTS
Operative time averaged 125 minutes, with a mean bleeding volume of 335 mL and mean hospital stay of 4.3 days. The rate of conversion to open surgery was 1.36% and the overall complication rate was 14.24%. The pathology analysis showed pT2 tumors in 82.60% and pT3 tumors in 17.39% of cases. The overall positive margin rate was 19.58%, with a biochemical recurrence of 10.27% at a mean follow-up of 62.5 months. Urinary continence and sexual potency yielded rates of 88% and 61%, respectively, 12 months after surgery.
CONCLUSIONS
Laparoscopic radical prostatectomy is a technically well-defined procedure that provides good oncologic and functional results after proper training.
Topics: Adult; Aged; Humans; Laparoscopy; Length of Stay; Male; Middle Aged; Neoplasm Staging; Prostatectomy; Prostatic Neoplasms; Time Factors; Treatment Outcome
PubMed: 19860935
DOI: 10.1590/s1677-55382009000500008 -
JAMA Oct 1971
Topics: Burns, Electric; Humans; Male; Malpractice; Prostatectomy; Transfusion Reaction; Urinary Incontinence
PubMed: 5171024
DOI: 10.1001/jama.218.4.651