Document Detail


Sural nerve grafting in robotic laparoscopic radical prostatectomy: interim report.
MedLine Citation:
PMID:  18044998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Sural nerve grafting for patients undergoing prostatectomy has been previously reported using open and minimally invasive methods. We report our experience with sural nerve grafting during robot-assisted laparoscopic radical prostatectomy (RLRP). MATERIALS AND METHODS: Patients with preoperative potency and a minimum of 6 months follow-up were included in this prospective review. A total of 333 patients were identified between February 2003 and January 2006 who met these criteria including 22 of the 25 patients who underwent sural nerve grafting. Patients were divided into 5 groups to compare unilateral and bilateral sural nerve cohorts with non-nerve-sparing and unilateral and bilateral nerve-sparing groups. Patients were followed prospectively using health-related quality-of-life questionnaires. RESULTS: Twenty-two patients underwent sural nerve grafting that included three bilateral grafts. Mean follow-up was 14 months. There was no statistical difference in patients' ages, body mass index, preoperative prostate-specific antigen level, blood loss, complications, and positive margin rate. Operative time was statistically longer for both sural graft cohorts when compared with unilateral (without graft) and bilateral nerve sparing cohorts. No significant differences in subjective or objective sexual function, sexual bother, or urinary function were seen with 6 and 12 months follow-up, possibly related to smaller sural cohorts. Graft-related complications include leg pain in one patient. CONCLUSION: Sural nerve grafting during RLRP is technically feasible and safe and offers improved dexterity and visualization deep within the pelvis. However, a larger randomized cohort of patients will be required to validate any improved benefits afforded by the robot system.
Authors:
Albert A Mikhail; David H Song; Kevin C Zorn; Marcelo A Orvieto; Jerome B Taxy; Shang P Lin; Frederick P Mendiola; Arieh L Shalhav; Gregory P Zagaja
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  21     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-01-11     Completed Date:  2008-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1547-51     Citation Subset:  IM    
Affiliation:
Department of Surgery, Section of Urology, The University of Chicago, Chicago, Illinois 60637, USA. almikhail@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Erectile Dysfunction / prevention & control*
Follow-Up Studies
Humans
Laparoscopy / methods*
Male
Middle Aged
Postoperative Complications / prevention & control
Prospective Studies
Prostatectomy / methods*
Prostatic Neoplasms / surgery*
Quality of Life
Questionnaires
Robotics / methods*
Sural Nerve / transplantation*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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