SURGICAL MODIFICATIONS OF RADICAL RETROPUBIC PROSTATECTOMY TO DECREASE INCIDENCE OF POSITIVE SURGICAL MARGINS
1998; Lippincott Williams & Wilkins; Volume: 159; Issue: 4 Linguagem: Inglês
10.1016/s0022-5347(01)63581-x
ISSN1527-3792
AutoresNejd F. Alsikafi, Charles B. Brendler,
Tópico(s)Urologic and reproductive health conditions
ResumoNo AccessJournal of UrologyClinical Urology: Original Articles1 Apr 1998SURGICAL MODIFICATIONS OF RADICAL RETROPUBIC PROSTATECTOMY TO DECREASE INCIDENCE OF POSITIVE SURGICAL MARGINS NEJD F. ALSIKAFI and CHARLES B. BRENDLER NEJD F. ALSIKAFINEJD F. ALSIKAFI and CHARLES B. BRENDLERCHARLES B. BRENDLER View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63581-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We sought to determine whether recent surgical modifications in the technique of radical retropubic prostatectomy decrease the incidence of positive surgical margins. Materials and Methods: We reviewed the records of 144 consecutive patients a mean of 60.8 years old who underwent radical retropubic prostatectomy using a modified surgical technique. Mean prostate specific antigen was 8.6 ng./ml. and mean Gleason grade was 5.8. Surgical modifications included division of the dorsal venous complex of the penis 10 to 15 mm. distal to the prostatic apex; transection of the urethra 3 mm. beyond the prostatic apex; division of the anterior aspect of the urethra, leaving the investing periurethral musculature intact, and division of the posterior aspect of the urethra en bloc with the striated urethral sphinter; sharp dissection of the rectourethralis muscle and remaining attachments of the prostate to the rectum; wide excision of the neurovascular bundle posterolateral to the prostate when adjacent induration or tumor is present, and division of the bladder neck, leaving a 5 mm. cuff of bladder tissue with the prostate. Results: Of 144 consecutive patients 16 (11.1%) had positive surgical margins at a total of 20 sites, including 7 (35%) at the apex, 8 (40%) posterolateral, 3 (15%) anterior and 2 (10%) at the bladder neck. 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Google Scholar Section of Urology, Department of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMagera J, Inman B, Slezak J, Bagniewski S, Sebo T and Myers R (2007) Increased Optical Magnification From 2.5× to 4.3× With Technical Modification Lowers the Positive Margin Rate in Open Radical Retropubic ProstatectomyJournal of Urology, VOL. 179, NO. 1, (130-135), Online publication date: 1-Jan-2008.TRABULSI E and GUILLONNEAU B (2018) LAPAROSCOPIC RADICAL PROSTATECTOMYJournal of Urology, VOL. 173, NO. 4, (1072-1079), Online publication date: 1-Apr-2005.HAN M, PARTIN A, CHAN D and WALSH P (2018) An Evaluation of the Decreasing Incidence of Positive Surgical Margins in a Large Retropubic Prostatectomy SeriesJournal of Urology, VOL. 171, NO. 1, (23-26), Online publication date: 1-Jan-2004.KATZ R, SALOMON L, HOZNEK A, de la TAILLE A, ANTIPHON P and ABBOU C (2018) Positive Surgical Margins in Laparoscopic Radical Prostatectomy: The Impact of Apical Dissection, Bladder Neck Remodeling and Nerve PreservationJournal of Urology, VOL. 169, NO. 6, (2049-2052), Online publication date: 1-Jun-2003.SHAH O, MELAMED J and LEPOR H (2018) ANALYSIS OF APICAL SOFT TISSUE MARGINS DURING RADICAL RETROPUBIC PROSTATECTOMYJournal of Urology, VOL. 165, NO. 6 Part 1, (1943-1949), Online publication date: 1-Jun-2001.THEODORESCU D, FRIERSON H and SIKES R (2018) MOLECULAR DETERMINATION OF SURGICAL MARGINS USING FOSSA BIOPSIES AT RADICAL PROSTATECTOMYJournal of Urology, VOL. 161, NO. 5, (1442-1448), Online publication date: 1-May-1999.RABBANI F, BASTAR A and FAIR W (2018) SITE SPECIFIC PREDICTORS OF POSITIVE MARGINS AT RADICAL PROSTATECTOMY: AN ARGUMENT FOR RISK BASED MODIFICATION OF TECHNIQUEJournal of Urology, VOL. 160, NO. 5, (1727-1733), Online publication date: 1-Nov-1998. Volume 159 Issue 4 April 1998 Page: 1281-1285 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.Metrics Author Information NEJD F. ALSIKAFI More articles by this author CHARLES B. BRENDLER More articles by this author Expand All Advertisement PDF downloadLoading ...
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