Mp37-03 Comparing Multiport Transperitoneal and Single Port Extraperitoneal Approaches in Salvage Robot-Assisted Radical Prostatectomy

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP37)1 May 2024MP37-03 COMPARING MULTIPORT TRANSPERITONEAL AND SINGLE PORT EXTRAPERITONEAL APPROACHES IN SALVAGE ROBOT-ASSISTED RADICAL PROSTATECTOMY Adriana Marcela Pedraza Bermeo, Roxana Ramos-Carpinteyro, Nicolas Soputro, Jaya Chavali, Carter Mikesell, and Jihad Kaouk Adriana Marcela Pedraza BermeoAdriana Marcela Pedraza Bermeo , Roxana Ramos-CarpinteyroRoxana Ramos-Carpinteyro , Nicolas SoputroNicolas Soputro , Jaya ChavaliJaya Chavali , Carter MikesellCarter Mikesell , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001008948.02935.01.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Single Port Robot-Assisted Radical Prostatectomy (SP RARP) has emerged as a promising alternative to Multiport (MP) approaches in the primary treatment setting, providing reduced morbidity and faster patient recovery. Our goal is to evaluate the feasibility of SP extraperitoneal RARP in a salvage scenario and compare its perioperative outcomes to conventional MP transperitoneal surgery. METHODS: From a prospectively maintained database, we identified 40 consecutive patients who underwent salvage RARP (sRARP) between 2013 and 2023 following radiotherapy or ablation. We analyzed outcomes for both MP and SP approaches. RESULTS: Baseline characteristics were similar between groups. The SP approach led to significantly shorter hospital stays (12.6 vs. 37.9 hours, p=0.03) and fewer opioid prescriptions at discharge (22.2% vs. 83.9%, p=0.003). Positive surgical margins were high overall, with no differences between SP and MP (44% vs. 35.5%, p=0.62). Lymph node yield was comparable (MP 8.1 vs. SP 7.8, p=0.89). Overall, patients undergoing sRARP had adverse features, including non-organ confined disease (77%), cribriform architecture (47.5%), and pN1 disease (12.5%). Only 17.5% of patients had a preoperative SHIM score ≥17, and all experienced severe or moderate erectile dysfunction after surgery. While SP-sRARP showed a trend towards better urinary continence at 6 months, it did not reach significance (55.6% vs. 25.0%, p=0.083). Intraoperative complications were absent, and postoperative complication rates were similar (MP 28% vs. SP 22.2%, p=0.68), mainly consisting of anastomotic leaks and urethrovesical anastomosis strictures. In this salvage cohort, the estimated 5-year BCR-free survival and CSS rates were 27% and 57%, respectively. CONCLUSIONS: SP extraperitoneal RARP is a viable salvage treatment for prostate cancer patients previously treated with radiation or ablation. It provides comparable functional and oncologic outcomes to MP transperitoneal surgery, with similar complication rates. The SP approach significantly shortens hospital stays and the need for opioid prescriptions at discharge, enabling outpatient procedures. This is the first report, to our knowledge, exploring SP extraperitoneal RARP in the salvage setting. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e602 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Adriana Marcela Pedraza Bermeo More articles by this author Roxana Ramos-Carpinteyro More articles by this author Nicolas Soputro More articles by this author Jaya Chavali More articles by this author Carter Mikesell More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...