title: Impact of prostate weight on perioperative outcomes of robot-assisted laparoscopic prostatectomy with a posterior approach to the seminal vesicle.
abstract: BACKGROUND
  To determine the effect of prostate weight on the preoperative and postoperative outcomes of robotic-assisted laparoscopic radical prostatectomy with a posterior approach to the seminal vesicle.
  
  
  METHODS
  This retrospective study examined prospectively collected data on 219 robotic-assisted laparoscopic radical prostatectomies performed from May 2011 to February 2013. Patients were divided into four groups based on pathologic prostate weight: <30 g, 30-49 g, 50-79 g, and ≥80 g. Continence and sexual function were assessed using validated questionnaires.
  
  
  RESULTS
  Of the 219 patients, 19, 143, 51, and 6 had prostates weighing <30 g, 30-49 g, 50-79 g, and ≥80 g, respectively. Significant differences were found between the preoperative Gleason scores, total operative times, and robotic times of the groups. Both estimated blood loss and anastomosis time tended to be greater in the higher prostate weight groups, but the differences were not significant. No significant differences were observed in transfusion rate, length of catheterization, complication incidence, or positive surgical margins. The return of urinary function, as determined by questionnaire scores, was not affected by prostate weight.
  
  
  CONCLUSIONS
  Robotic-assisted laparoscopic radical prostatectomy can be performed safely and with similar perioperative outcomes, regardless of prostate weight. Indeed, oncological outcome, urinary continence, and complications were similar across the prostate weight groups, suggesting that robotic-assisted laparoscopic radical prostatectomy with a posterior approach to the seminal vesicle may be performed effectively on men with large prostates, despite greater surgical times.
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan. yasui@med.nagoya-cu.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasui
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tozawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurokawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okada
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mizuno
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Umemoto
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Kawai
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D009929:Organ Size; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D059035:Perioperative Period; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D012669:Seminal Vesicles / Q000473:pathology / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult