Safety and Clinical Outcomes of Robot-Assisted Radical Prostatectomy in Kidney Transplant Patients: A Systematic Review

Jiping Zeng, Andrew Christiansen, Aydin Pooli, Fang Qiu, Chad A LaGrange

Research output: Contribution to journalReview article

Abstract

Objective: To evaluate the safety and outcomes of robot-Assisted radical prostatectomy (RARP) in renal transplant recipients (RTRs) based on available literature. Materials and Methods: A literature search was performed using PubMed, Embase, and Web of Science through "robot" AND "prostatectomy" AND "transplant." Three authors separately reviewed the records to select the relevant articles with any discrepancies solved by open discussion. Patient age, prostate-specific antigen, Gleason score, and tumor stage were recorded as well as intraoperative and postoperative complications, length of stay, surgical margin status, and disease recurrence, if provided. The operative techniques and modification/adjustments to standard port placements were also reviewed. We also include our case report in this review. Results: We retrieved 10 articles reporting clinical data on RARP for kidney transplant patients, including 5 case series (level 4) and 5 case reports (level 4). A total of 35 kidney transplant recipients undergoing RARP were analyzed in this systematic review, one case in our institution included. None of the cases had major technical difficulties precluding the operation. Technical modifications to the standard technique were described in 10 of the 11 articles specifically including modifications to port placement (54% of patients), development of the space of Retzius (60% of patients), and performance of lymphadenectomy. Mean operative time was 220 minutes. Perioperative complication rate was 17.1% (6 of 35 patients), with only one Clavien III or greater complication. The rate of positive surgical margins was found to be 31.4%. Data on biochemical recurrence revealed a combined rate of 18.1%. Conclusions: RARP is technically feasible for treating localized prostate cancer in RTRs. Graft function did not deteriorate in any patient. Modifications to the standard technique should be considered specifically for port placement, development of the space of Retzius, and performance of lymphadenectomy. Oncologic outcomes remain difficult to interpret given the small number of reported cases.

Original languageEnglish (US)
Pages (from-to)935-943
Number of pages9
JournalJournal of Endourology
Volume32
Issue number10
DOIs
StatePublished - Oct 2018

Fingerprint

Prostatectomy
Transplants
Kidney
Safety
Lymph Node Excision
Recurrence
Neoplasm Grading
Intraoperative Complications
Prostate-Specific Antigen
Operative Time
PubMed
Length of Stay
Prostatic Neoplasms
Research Design
Transplant Recipients
Neoplasms

Keywords

  • kidney transplant
  • prostate cancer
  • robot-Assisted radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Safety and Clinical Outcomes of Robot-Assisted Radical Prostatectomy in Kidney Transplant Patients : A Systematic Review. / Zeng, Jiping; Christiansen, Andrew; Pooli, Aydin; Qiu, Fang; LaGrange, Chad A.

In: Journal of Endourology, Vol. 32, No. 10, 10.2018, p. 935-943.

Research output: Contribution to journalReview article

Zeng, Jiping ; Christiansen, Andrew ; Pooli, Aydin ; Qiu, Fang ; LaGrange, Chad A. / Safety and Clinical Outcomes of Robot-Assisted Radical Prostatectomy in Kidney Transplant Patients : A Systematic Review. In: Journal of Endourology. 2018 ; Vol. 32, No. 10. pp. 935-943.
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AU - LaGrange, Chad A

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N2 - Objective: To evaluate the safety and outcomes of robot-Assisted radical prostatectomy (RARP) in renal transplant recipients (RTRs) based on available literature. Materials and Methods: A literature search was performed using PubMed, Embase, and Web of Science through "robot" AND "prostatectomy" AND "transplant." Three authors separately reviewed the records to select the relevant articles with any discrepancies solved by open discussion. Patient age, prostate-specific antigen, Gleason score, and tumor stage were recorded as well as intraoperative and postoperative complications, length of stay, surgical margin status, and disease recurrence, if provided. The operative techniques and modification/adjustments to standard port placements were also reviewed. We also include our case report in this review. Results: We retrieved 10 articles reporting clinical data on RARP for kidney transplant patients, including 5 case series (level 4) and 5 case reports (level 4). A total of 35 kidney transplant recipients undergoing RARP were analyzed in this systematic review, one case in our institution included. None of the cases had major technical difficulties precluding the operation. Technical modifications to the standard technique were described in 10 of the 11 articles specifically including modifications to port placement (54% of patients), development of the space of Retzius (60% of patients), and performance of lymphadenectomy. Mean operative time was 220 minutes. Perioperative complication rate was 17.1% (6 of 35 patients), with only one Clavien III or greater complication. The rate of positive surgical margins was found to be 31.4%. Data on biochemical recurrence revealed a combined rate of 18.1%. Conclusions: RARP is technically feasible for treating localized prostate cancer in RTRs. Graft function did not deteriorate in any patient. Modifications to the standard technique should be considered specifically for port placement, development of the space of Retzius, and performance of lymphadenectomy. Oncologic outcomes remain difficult to interpret given the small number of reported cases.

AB - Objective: To evaluate the safety and outcomes of robot-Assisted radical prostatectomy (RARP) in renal transplant recipients (RTRs) based on available literature. Materials and Methods: A literature search was performed using PubMed, Embase, and Web of Science through "robot" AND "prostatectomy" AND "transplant." Three authors separately reviewed the records to select the relevant articles with any discrepancies solved by open discussion. Patient age, prostate-specific antigen, Gleason score, and tumor stage were recorded as well as intraoperative and postoperative complications, length of stay, surgical margin status, and disease recurrence, if provided. The operative techniques and modification/adjustments to standard port placements were also reviewed. We also include our case report in this review. Results: We retrieved 10 articles reporting clinical data on RARP for kidney transplant patients, including 5 case series (level 4) and 5 case reports (level 4). A total of 35 kidney transplant recipients undergoing RARP were analyzed in this systematic review, one case in our institution included. None of the cases had major technical difficulties precluding the operation. Technical modifications to the standard technique were described in 10 of the 11 articles specifically including modifications to port placement (54% of patients), development of the space of Retzius (60% of patients), and performance of lymphadenectomy. Mean operative time was 220 minutes. Perioperative complication rate was 17.1% (6 of 35 patients), with only one Clavien III or greater complication. The rate of positive surgical margins was found to be 31.4%. Data on biochemical recurrence revealed a combined rate of 18.1%. Conclusions: RARP is technically feasible for treating localized prostate cancer in RTRs. Graft function did not deteriorate in any patient. Modifications to the standard technique should be considered specifically for port placement, development of the space of Retzius, and performance of lymphadenectomy. Oncologic outcomes remain difficult to interpret given the small number of reported cases.

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