Abstract
Radical prostatectomy (RP) is the standard surgical treatment of organ-confined prostate cancer in patients with a life expectancy of at least 10 years. In a recent prospective study, we described the PERUSIA (Posterior, Extraperitoneal, Robotic, Under Santorini, Intrafascial, Anterograde) technique, which is an extraperitoneal full nerve sparing robotic RP, showing its feasibility and safety. The aim of this retrospective study was to evaluate the peri-operative, oncologic, and functional outcomes of the PERUSIA technique. We retrospectively analyzed the data of 454 robotic-assisted radical prostatectomies (RARP) performed using the PERUSIA technique from January 2012 to October 2019. We evaluated perioperative outcomes (operative time, estimated blood loss, catheterization time, complication rate, length of stay), oncological (positive surgical margins and biochemical recurrence), and functional outcomes in terms of urinary continence and sexual potency. The overall complication rate was 16%, positive surgical margins were 8.1%, and biochemical recurrence occurred in 8.6% at median follow-up of 47 months. Urinary continence was achieved in 69% of cases the day after the removal of the catheter, in 92% at 3 months, and in 97% at 12 months after surgery. The average rate of sexual potency was 72% and 82% respectively 3 and 12 months after surgery. Our findings show that the PERUSIA technique is a safe extraperitoneal approach to perform a full nerve sparing technique providing exciting functional outcomes.
Highlights
Prostate cancer (PCa) is the second most common malignant neoplasm in the male population
In a recent prospective study, we described the PERUSIA technique, an extraperitoneal full nerve-sparing robotic Radical prostatectomy (RP), showing its feasibility and safety [10]
robotic-assisted radical prostatectomies (RARP) were performed from April 2011 to April 2020 in our high-volume center
Summary
Prostate cancer (PCa) is the second most common malignant neoplasm in the male population. In 2019, the prevalence in the USA was over 3,650,000 cases, while the new diagnoses were 174,950 [1]. Even more interesting is the estimated prevalence for 2030 of over 5 million cases, which is emblematic of cancer being in continuous evolution [2]. Radical prostatectomy (RP) is the standard surgical treatment of organ-confined PCa in patients with a life expectancy of at least 10 years [2]. Thanks to continuous technological progress, over the last few decades, there has been a continuous evolution of surgical techniques that have led to an ever-greater application of laparoscopy first and of robotics
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