title: Robot Assisted Radical Prostatectomy in Kidney Transplant Recipients. Our Clinical Experience and a Systematic Review.
abstract: BACKGROUND
  Radical prostatectomy is a more skillful procedure in kidney graft recipients. Robotic surgery can provide a useful minimally invasive tool.
  
  
  OBJECTIVE
  The study aims to evaluate the robotic-assisted laparoscopic prostatectomy (RALP) in kidney transplant recipients, describing intra/postoperative complications, renal and oncological outcomes.
  
  
  METHODS
  This is a retrospective study conducted in a single institution of 84 RALP. Four of them were kidney transplant recipients. Side of the renal graft, clinical stage, intra/postoperative events, operating time, creatinine levels before/after intervention and oncologic follow-up were recorded. A systematic review of the literature was performed.
  
  
  RESULTS
  Aged 61.25 ± 7.76 years, interval between renal transplantation and RALP: 10 ± 3.16 years. Mean prostate specific antigen: 7.1 ± 2.8 ng/ml, 2 patients were cT1c and 2 cT2a. Preoperative biopsies: Gleason score 3 + 3 in 3 patients, 3 + 4 in 1 patient. Charlson comorbidity index mean was 4.82 ± 0.82. No intra/postoperative events were reported. Mean operating time: 196 ± 20.8 min. Positive surgical margins: 2/4 patients. Pathological analysis: Gleason 3 + 4 in 2 patients and Gleason 3 + 3 in the others 2. A patient developed a bladder neck sclerosis. No differences between pre/postoperative creatinine. Three patients are free of biochemical recurrence and 1 patient required adjuvant radiotherapy.
  
  
  CONCLUSIONS
  RALP in renal transplant recipients is a safe and feasible technique for localized prostate cancer. No difference in oncological outcomes and no impairments on renal function were found.
authors.affiliation: Servicio de Urología, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Moreno Sierra
authors.forename: M
authors.initials: M
authors.lastname: Ciappara Paniagua
authors.forename: M I
authors.initials: MI
authors.lastname: Galante Romo
authors.forename: J L
authors.initials: JL
authors.lastname: Senovilla Pérez
authors.forename: E
authors.initials: E
authors.lastname: Redondo González
authors.forename: M I
authors.initials: MI
authors.lastname: Galindo Herrero
authors.forename: N
authors.initials: N
authors.lastname: Novo Gómez
authors.forename: J
authors.initials: J
authors.lastname: Blázquez Izquierdo
mesh_terms: D006801:Humans; D016030:Kidney Transplantation; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms; D012189:Retrospective Studies; D012371:Robotics