Dados do Trabalho

Título

PERITONEAL FLAP FOLLOWING LYMPH NODE DISSECTION IN ROBOTIC RADICAL PROSTATECTOMY: A NOVEL “BUNCHING” TECHNIQUE

Resumo

Background: Pelvic lymph node dissection (PLND) is recommended while performing robot-assisted radical prostatectomy (RARP) for patients with localized intermediate or high-risk prostate cancer. However, symptomatic lymphoceles can occur after surgery in up to 15% of patients.Our objective is to describe a a novel Peritoneal Bladder Flap Bunching technique (PBFB) to reduce the risk of clinically significant lymphoceles in patients undergoing RARP and PLND.Methods: We evaluated 2,267 patients who underwent RARP with PLND, dividing them into two groups: Group 1, 567 patients who had the peritoneal flap (PBFB), and Group 2, 1,700 patients without the flap, a propensity score matching done in a 1:3 ratio. Variables analyzed included estimated blood loss (EBL), operative time, postoperative complications, lymphocele formation and development of symptomatic lymphocele. Results: The two groups exhibited similar preoperative characteristics after matching. There was no statistically significant difference in the occurrence of lymphoceles between the flap group and the non-flap group, with rates of 24 % and 20.9%, respectively (P=0.14). However, none of the patients in the flap group (0%) developed symptomatic lymphoceles, whereas 2.2% of patients in the non-flap group experienced symptomatic lymphoceles (P=0.01). Conclusion: We have demonstrated a modified technique of peritoneal flap (PBFB) with initial elimination of postoperative symptomatic lymphoceles and promising short-term outcomes.

Key Words: Radical Prostatectomy; Robotic assisted; Pelvic Lymph Node Dissection; Lymphocele; Symptomatic Lymphoceles; Peritoneal Flap