Cavernosal Nerve Preservation During Robot-assisted Radical Prostatectomy Is a Graded Rather Than an All-or-none Phenomenon: Objective Demonstration by Assessment of Residual Nerve Tissue on Surgical Specimens

Title
Cavernosal Nerve Preservation During Robot-assisted Radical Prostatectomy Is a Graded Rather Than an All-or-none Phenomenon: Objective Demonstration by Assessment of Residual Nerve Tissue on Surgical Specimens
Author(s)
고영휘Schatloff, Oscar[Schatloff, Oscar]Chauhan, Sanket[Chauhan, Sanket]Kameh, Darian[Kameh, Darian]Valero, Rair[Valero, Rair](Sivaraman, Ananthakrishnan[(Sivaraman, Ananthakrishnan]Coelho, Rafael F[Coelho, Rafael F]Marquinez, Jeff[Marquinez, Jeff]Palmer, Kenneth J[Palmer, Kenneth J]Patel, Vipul R[Patel, Vipul R]
Keywords
SUBJECTIVE CHARACTERIZATION; ERECTILE FUNCTION; OUTCOMES; POTENCY; CANCER; RECOVERY; QUALITY; SURGEON; STAGE
Issue Date
201203
Publisher
ELSEVIER SCIENCE INC
Citation
UROLOGY, v.79, no.3, pp.596 - 600
Abstract
OBJECTIVE To demonstrate the existence of different degrees of nerve sparing (NS) (graded NS) by comparing the surgeon's intent of NS with the residual nerve tissue on prostatectomy specimens. METHODS We performed a prospective study of 133 consecutive patients who underwent robot-assisted radical prostatectomy in January and February of 2011. The surgeon graded the amount of NS intraoperatively independently for either side as follows: 1, no NS; 2, <50% NS; 3, 50% NS; 4, 75% NS; and 5, >= 95% NS. A pathologist who was unaware of the surgeon's score measured the area of residual nerve tissue on the posterolateral surface of the prostate. RESULTS A greater NS score correlated significantly with a decreasing area of residual nerve tissue on the prostatectomy specimens (P < .001). Overall, the area of residual nerve tissue on the prostatectomy specimens was significantly different among the NS groups (P < .001). On specific intergroup analysis, significant differences were found in the area of residual nerve tissue on the prostatectomy specimens between the greater NS groups: NS score 3 versus 4, median 13 mm(2) (interquartile range [IQR] 7-23) versus 3 mm(2) (IQR 0-8; P = .01); NS score 4 versus 5, median 3 mm(2) (IQR 0-8) versus 0.5 mm(2) (IQR 0-2; P = .001). CONCLUSION Subjective NS classification using the surgeon's intraoperative perception correlated significantly with the area of residual nerve tissue on the prostatectomy specimens determined by the pathologist. It is possible to intentionally tailor the amount of NS performed at surgery. This finding demonstrates that NS is a graded rather than an all-or-none phenomenon that can even go beyond the traditional concept of complete, partial, or no NS. UROLOGY 79: 596-600, 2012. (C) 2012 Elsevier Inc.
URI
http://hdl.handle.net/YU.REPOSITORY/29498http://dx.doi.org/10.1016/j.urology.2011.11.029
ISSN
0090-4295
Appears in Collections:
의과대학 > 비뇨기과학교실 > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE