{"id":1538,"date":"2021-09-30T16:28:27","date_gmt":"2021-09-30T14:28:27","guid":{"rendered":"https:\/\/drstefanopuliatti.com\/non-categorizzato\/the-impact-of-previous-prostate-surgery-on-surgical-outcomes-for-patients-treated-with-robot-assisted-radical-cystectomy-for-bladder-cancer\/"},"modified":"2021-09-30T16:28:27","modified_gmt":"2021-09-30T14:28:27","slug":"the-impact-of-previous-prostate-surgery-on-surgical-outcomes-for-patients-treated-with-robot-assisted-radical-cystectomy-for-bladder-cancer","status":"publish","type":"post","link":"https:\/\/drstefanopuliatti.com\/en\/scientific-articles\/the-impact-of-previous-prostate-surgery-on-surgical-outcomes-for-patients-treated-with-robot-assisted-radical-cystectomy-for-bladder-cancer\/","title":{"rendered":"The Impact of Previous Prostate Surgery on Surgical Outcomes for Patients Treated with Robot-assisted Radical Cystectomy for Bladder Cancer"},"content":{"rendered":"[vc_row type=&#8221;in_container&#8221; full_screen_row_position=&#8221;middle&#8221; column_margin=&#8221;default&#8221; column_direction=&#8221;default&#8221; column_direction_tablet=&#8221;default&#8221; column_direction_phone=&#8221;default&#8221; scene_position=&#8221;center&#8221; text_color=&#8221;dark&#8221; text_align=&#8221;left&#8221; row_border_radius=&#8221;none&#8221; row_border_radius_applies=&#8221;bg&#8221; overlay_strength=&#8221;0.3&#8243; gradient_direction=&#8221;left_to_right&#8221; shape_divider_position=&#8221;bottom&#8221; bg_image_animation=&#8221;none&#8221;][vc_column column_padding=&#8221;no-extra-padding&#8221; column_padding_tablet=&#8221;inherit&#8221; column_padding_phone=&#8221;inherit&#8221; column_padding_position=&#8221;all&#8221; column_element_spacing=&#8221;default&#8221; background_color_opacity=&#8221;1&#8243; background_hover_color_opacity=&#8221;1&#8243; column_shadow=&#8221;none&#8221; column_border_radius=&#8221;none&#8221; column_link_target=&#8221;_self&#8221; gradient_direction=&#8221;left_to_right&#8221; overlay_strength=&#8221;0.3&#8243; width=&#8221;1\/1&#8243; tablet_width_inherit=&#8221;default&#8221; tablet_text_alignment=&#8221;default&#8221; phone_text_alignment=&#8221;default&#8221; bg_image_animation=&#8221;none&#8221; border_type=&#8221;simple&#8221; column_border_width=&#8221;none&#8221; column_border_style=&#8221;solid&#8221;][vc_column_text]Giuseppe Rosiello, Pietro Piazza, Victor Tames, Rui Farinha, Artur Paludo, Stefano Puliatti, Marco Amato, Elio Mazzone, Ruben De Groote, Camille Berquin, Dries Develtere, Ralf Veys, Celine Sinatti, Riccardo Schiavina, Geert De Naeyer, Peter Schatteman, Paul Carpentier, Francesco Montorsi, Frederiek D&#8217;Hondt, Alexandre Mottrie[\/vc_column_text][\/vc_column][\/vc_row][vc_row type=&#8221;in_container&#8221; full_screen_row_position=&#8221;middle&#8221; column_margin=&#8221;default&#8221; column_direction=&#8221;default&#8221; column_direction_tablet=&#8221;default&#8221; column_direction_phone=&#8221;default&#8221; scene_position=&#8221;center&#8221; text_color=&#8221;dark&#8221; text_align=&#8221;left&#8221; row_border_radius=&#8221;none&#8221; row_border_radius_applies=&#8221;bg&#8221; overlay_strength=&#8221;0.3&#8243; gradient_direction=&#8221;left_to_right&#8221; shape_divider_position=&#8221;bottom&#8221; bg_image_animation=&#8221;none&#8221;][vc_column column_padding=&#8221;no-extra-padding&#8221; column_padding_tablet=&#8221;inherit&#8221; column_padding_phone=&#8221;inherit&#8221; column_padding_position=&#8221;all&#8221; column_element_spacing=&#8221;default&#8221; background_color_opacity=&#8221;1&#8243; background_hover_color_opacity=&#8221;1&#8243; column_shadow=&#8221;none&#8221; column_border_radius=&#8221;none&#8221; column_link_target=&#8221;_self&#8221; gradient_direction=&#8221;left_to_right&#8221; overlay_strength=&#8221;0.3&#8243; width=&#8221;1\/1&#8243; tablet_width_inherit=&#8221;default&#8221; tablet_text_alignment=&#8221;default&#8221; phone_text_alignment=&#8221;default&#8221; bg_image_animation=&#8221;none&#8221; border_type=&#8221;simple&#8221; column_border_width=&#8221;none&#8221; column_border_style=&#8221;solid&#8221;][vc_column_text]\n<ul>\n<li><span class=\"identifier pubmed\"><span class=\"id-label\">PMID:\u00a0<\/span><strong class=\"current-id\" title=\"PubMed ID\">33653634<\/strong><\/span><\/li>\n<li><span class=\"identifier doi\"><span class=\"id-label\">DOI:\u00a0<\/span><a class=\"id-link\" href=\"https:\/\/doi.org\/10.1016\/j.eururo.2021.02.029\" target=\"_blank\" rel=\"noopener\" data-ga-category=\"full_text\" data-ga-action=\"DOI\">10.1016\/j.eururo.2021.02.029<\/a><\/span><\/li>\n<\/ul>\n[\/vc_column_text][nectar_btn size=&#8221;jumbo&#8221; open_new_tab=&#8221;true&#8221; button_style=&#8221;regular&#8221; button_color_2=&#8221;Accent-Color&#8221; icon_family=&#8221;none&#8221; text=&#8221;full article at pubmed.gov&#8221; url=&#8221;https:\/\/pubmed.ncbi.nlm.nih.gov\/33653634\/&#8221;][\/vc_column][\/vc_row][vc_row type=&#8221;in_container&#8221; full_screen_row_position=&#8221;middle&#8221; column_margin=&#8221;default&#8221; column_direction=&#8221;default&#8221; column_direction_tablet=&#8221;default&#8221; column_direction_phone=&#8221;default&#8221; scene_position=&#8221;center&#8221; text_color=&#8221;dark&#8221; text_align=&#8221;left&#8221; row_border_radius=&#8221;none&#8221; row_border_radius_applies=&#8221;bg&#8221; overlay_strength=&#8221;0.3&#8243; gradient_direction=&#8221;left_to_right&#8221; shape_divider_position=&#8221;bottom&#8221; bg_image_animation=&#8221;none&#8221;][vc_column column_padding=&#8221;no-extra-padding&#8221; column_padding_tablet=&#8221;inherit&#8221; column_padding_phone=&#8221;inherit&#8221; column_padding_position=&#8221;all&#8221; column_element_spacing=&#8221;default&#8221; background_color_opacity=&#8221;1&#8243; background_hover_color_opacity=&#8221;1&#8243; column_shadow=&#8221;none&#8221; column_border_radius=&#8221;none&#8221; column_link_target=&#8221;_self&#8221; gradient_direction=&#8221;left_to_right&#8221; overlay_strength=&#8221;0.3&#8243; width=&#8221;1\/1&#8243; tablet_width_inherit=&#8221;default&#8221; tablet_text_alignment=&#8221;default&#8221; phone_text_alignment=&#8221;default&#8221; bg_image_animation=&#8221;none&#8221; border_type=&#8221;simple&#8221; column_border_width=&#8221;none&#8221; column_border_style=&#8221;solid&#8221;][vc_column_text]\n<h4>Abstract<\/h4>\n[\/vc_column_text][vc_column_text]<strong>Background:<\/strong> The feasibility and safety of robot-assisted radical cystectomy (RARC) may be undermined by unfavorable preoperative surgical characteristics such as previous prostate surgery (PPS).<\/p>\n<p><strong>Objective:<\/strong> To compare perioperative outcomes for patients undergoing RARC with versus without a history of PPS.<\/p>\n<p><strong>Design, setting, and participants:<\/strong> The study included 220 consecutive patients treated with RARC and pelvic lymph node dissection for bladder cancer at a single European tertiary centre. Of these, 43 had previously undergone PPS, defined as transurethral resection of the prostate\/holmium laser enucleation of the prostate (n=21) or robot-assisted radical prostatectomy (n=22).<\/p>\n<p><strong>Surgical procedure:<\/strong> RARC in patients with a history of PPS.<\/p>\n<p><strong>Measurements:<\/strong> Data on postoperative complications were collected according to the quality criteria for accurate and comprehensive reporting of surgical outcomes recommended by the European Association of Urology guidelines. Multivariable logistic, linear, and Poisson regression analyses were performed to test the effect of PPS on surgical outcomes.<\/p>\n<p><strong>Results and limitations:<\/strong> Overall, 43 patients (20%) were treated with RARC after PPS. Operative time (OT) was longer in the PPS group (360 vs 330min; p&lt;0.001). Patients with PPS experienced higher rates of intraoperative complications (19% vs 6.8%) and higher rates of 30-d (67% vs 39%), and Clavien-Dindo &gt;3 (33% vs 16%) postoperative complications (all p&lt;0.05). Moreover, the positive surgical margin (PSM) rate after RARC was higher in the PPS group (14% vs 4%; p=0.03). On multivariable analyses, PPS at RARC independently predicted higher risk of intraoperative (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.04-6.21; p=0.01) and 30-d complications (OR 2.26, 95% CI 1.05-5.22; p=0.02), as well as longer OT (relative risk [RR] 1.03, 95% CI 1.00-1.05; p=0.02) and length of stay (RR 1.13, 95% CI 1.02-1.26; p=0.02). Lack of randomization represents the main limitation.<\/p>\n<p><strong>Conclusions:<\/strong> RARC in patients with a history of PPS is feasible, but it is associated with a higher risk of complications and longer OT and length of stay. Moreover, higher PSM rates have been reported for these patients. Thus, measures aimed at improving surgical outcomes appear to be warranted.<\/p>\n<p><strong>Patient summary:<\/strong> We investigated the effect of previous prostate surgery (PPS) on surgical outcomes after robot-assisted removal of the bladder. We found that patients with PPS have a higher risk of complications and longer hospitalization after bladder removal. These patients deserve closer evaluation before this type of bladder operation.<\/p>\n<p><strong>Keywords:<\/strong> Bladder cancer; Complications; Minimally invasive surgery; Radical prostatectomy; Transurethral resection of the prostate.<\/p>\n<p>Copyright \u00a9 2021 European Association of Urology. Published by Elsevier B.V. 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Da Luglio 2019 ricopre il ruolo di Assistant Professor in Urologia presso l'Universit\u00e0 di Modena e Reggio Emilia. Da Luglio 2019 ricopre anche il ruolo di Deputy Medical Director of ORSI Academy, Melle, Belgio e svolge attivit\u00e0 clinica e chirurgica presso OLV (Onze Lieve Vrouwziekenhuis) Hospital in Aalst, Belgio (direttore: Prof. Alex Mottrie). La sua formazione si \u00e8 incentrata in particolare sulla Chirurgia robotica e oncologica delle vie urinarie, avendo come principali campi di applicazione anche tumori e malattie della prostata, tumori del rene e delle alte vie urinarie, disturbi minzionali, calcolosi delle vie urinarie. \u00c8 inoltre autore e coautore di articoli scientifici e capitoli di libro in ambito urologico. Attualmente svolge attivit\u00e0 in libera professione presso diverse strutture situate a Modena e Provincia.","url":"https:\/\/drstefanopuliatti.com\/en\/author\/stefano-puliatti\/"}]}},"_links":{"self":[{"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/posts\/1538","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/comments?post=1538"}],"version-history":[{"count":0,"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/posts\/1538\/revisions"}],"wp:attachment":[{"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/media?parent=1538"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/categories?post=1538"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drstefanopuliatti.com\/en\/wp-json\/wp\/v2\/tags?post=1538"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}