title: Transperitoneal laparoscopic prostatectomy does not increase small bowel within the target volume for postoperative radiotherapy.
abstract: OBJECTIVE
  Laparoscopic or robot assisted laparoscopic radical prostatectomy is often performed via a transperitoneal approach for prostate cancer, in contrast to open retropubic radical prostatectomy. Theoretically transgressing the peritoneum may introduce small bowel loops into the pelvis, increasing the risk of small bowel injury with adjuvant radiotherapy. We compared the incidence of small bowel within the planning target volume for radiotherapy to the prostate bed in patients who underwent open retropubic and laparoscopic radical prostatectomy.
  
  
  METHODS
  A total of 25 patients recently treated with laparoscopic radical prostatectomy prospectively provided consent to undergo radiotherapy planning computerized tomography simulation to assess the incidence of small bowel within the prostate bed planning target volume. These studies were compared to radiotherapy planning computerized tomography in 50 patients who underwent open retropubic radical prostatectomy and received adjuvant or salvage radiotherapy for prostate cancer. For all computerized tomography images 1 blinded observer delineated the distal small bowel loops and 1 blinded radiation oncologist delineated the superior extent of clinical and planning target volumes.
  
  
  RESULTS
  The overlap rate between small bowel and planning target volume was 16% in the laparoscopic and open radical prostatectomy groups (p = 0.579).
  
  
  CONCLUSIONS
  There is no difference between transperitoneal laparoscopic and open retropubic radical prostatectomy in the incidence of small bowel within the planning target volume for radiotherapy to the prostate bed. Thus, patients who undergo transperitoneal laparoscopic radical prostatectomy do not face a higher risk of toxicity or compromise due to adjuvant or salvage radiotherapy should they require it.
authors.affiliation: Princess Margaret Hospital, Toronto, Ontario, Canada. a.finelli@utoronto.ca
authors.forename: Antonio
authors.initials: A
authors.lastname: Finelli
authors.forename: Sanoj
authors.initials: S
authors.lastname: Punnen
authors.forename: Tara
authors.initials: T
authors.lastname: Rosewall
authors.forename: Charles
authors.initials: C
authors.lastname: Catton
authors.forename: Neil
authors.initials: N
authors.lastname: Fleshner
authors.forename: Michael
authors.initials: M
authors.lastname: Jewett
authors.forename: John
authors.initials: J
authors.lastname: Trachtenberg
authors.forename: Cynthia
authors.initials: C
authors.lastname: Menard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003131:Combined Modality Therapy; D006801:Humans; D007421:Intestine, Small / Q000293:injuries*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011159:Population Surveillance; D011182:Postoperative Care; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects