One Doc's first 500 robotic RPs

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/25/2009 3:21 PM (GMT -6)   
Robotic radical prostatectomy: outcomes of 500 cases
Vipul R. Patel, Rahul Thaly and Ketul Shah
British Journal of Urology International v 99 I 5 pp1109-1112 (2007)

I find this a very interesting document because it reports on the first 500 robotic surgeries performed by a single surgeon at Ohio State University.. There were only two complications, both rectal injuries, and both occurring in the first 25 operations. They were detected and corrected lapriscopicaly during the operation.

Positive margins by number of operations performed
Overall -- 9.4% (by stage: T3b – 46%, T3a -- 23%, T2 – 2.5%)
first 100 -- 13%
second 100 -- 8%
third 100 -- 13%
fourth 100 -- 5%
last 100 -- 8%
This is not quite as straightforward as it may seem because, as their number of surgeries increased, they accepted more complex cases. Factors which added complexity were obesity, a history of TURP, and a prostate greater than 100g.

For the 173 patients who are more than one year after surgery 95% have a PSA <0.1

Some other information:
Complete continence (no pads)
At catheter removal – 27%
At 3 months – 89%
At 6 months – 95%
At 12 months – 97%
Greater experience resulted in faster return to continence

For the 200 patients who had adequate sexual function before surgery
and who had nerve sparing on one or both sides.
One year after surgery
78% capable of intercourse (includes those using oral medications)
7% capable of intercourse using injections
15% did not have erections capable of intercourse
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
At 10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25371
   Posted 6/25/2009 4:07 PM (GMT -6)   
Some good and interesting stats there
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 

New Topic Post Reply Printable Version
Forum Information
Currently it is Tuesday, May 22, 2018 10:53 PM (GMT -6)
There are a total of 2,965,187 posts in 325,220 threads.
View Active Threads


Who's Online
This forum has 162941 registered members. Please welcome our newest member, haohanfan3.
288 Guest(s), 4 Registered Member(s) are currently online.  Details
Flying gal, Lymebgone, mtnwife, Alex ArmPain