title: Robotic or open radical prostatectomy after previous open surgery in the pelvic region.
abstract: OBJECTIVE
  We sought to evaluate the feasibility and safety of open or robotic radical prostatectomy (RP) after rectum, sigmoid, or colon surgery.
  
  
  METHODS
  Sixty-four patients with a median age of 65 years (range, 46-73 years) who underwent RP after previous pelvic surgery were included. Twenty-four patients (38%) underwent robotic RP and 40 patients (62%) underwent open RP. Bilateral lymph node dissection and nerve preservation were performed in 50 patients (78%) and 35 patients (55%), respectively. Variables evaluated included demographic characteristics, perioperative complications, and functional and oncological outcomes. The median hospitalization and follow-up periods were 2 days (range, 1-12 days) and 21 months (range, 1-108 months), respectively.
  
  
  RESULTS
  No conversions from robotic to open surgery were performed and there were no intraoperative complications. Surgical margins were positive in 13 patients (20%), seminal vesicle involvement was detected in 6 patients (9%), and lymph node involvement was found in 2 patients (3%). Postoperative complications included lymphocele in 1 patient, urethral stricture in 1 patient, and bowel obstruction and persistent bladder leakage in 2 patients. Eighty-eight percent of the patients were continent at 7 months and 80% of patients were able to achieve erection with or without medical aid.
  
  
  CONCLUSIONS
  Open or robotic RP can be done safely and effectively in patients who have previously undergone pelvic surgery. Although prior pelvic surgery of the large intestine was associated with increased morbidity, it should not be considered a contraindication for robotic or open RP.
authors: Department of Urology, An-Najah National University Hospital, Nablus, Palestine.
authors: Mahmoud
authors: M
authors: Mustafa
authors: MD Anderson Cancer Center, Huston, TX, USA.
authors: Curtis A
authors: CA
authors: Pettaway
authors: MD Anderson Cancer Center, Huston, TX, USA.
authors: John W
authors: JW
authors: Davis
authors: MD Anderson Cancer Center, Huston, TX, USA.
authors: Louis
authors: L
authors: Pisters
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D006801:Humans; D007420:Intestine, Large / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Prostate; Prostate neoplasms; Prostatectomy; Robotics; Surgery