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Consistent Bladder Neck Sparing During Robotic Assisted Laparoscopic Radical Prostatectomy
Lei Yin, MD, Aaron C. Weinberg, PHD, Marcos P. Freire, PHD, Sergey K. Kravichick, MD, Xiangmei Gu, PHD, Stuart R. Lipsitz, PHD, Jim C. Hu, MD , PhD.
Brigham & Women's Hospital, Boston, MA, USA.

Introduction and Objective:
To evaluate the effects of a single change in surgical technique on perioperative outcomes in patients undergoing robotic assisted laparoscopic radical prostatectomy.

METHODS:
We compared perioperative outcomes in our consecutive series of 536 men who underwent robotic assisted laparoscopic radical prostatectomy through Brigham and Women’s Hospital from 10/14/2005 to 03/20/2009. The Patients were divided into 2 groups :A bladder neck sparing technique was used in 293 patients(Group 1),and 260 patients (Group 2) underwent RALRP without bladder neck sparing . For each patient we recorded preoperative, perioperative, postoperative and pathological data variables. Postoperative bleeding was assessed by calculating the difference between recovery room and hospital discharge HCT.

RESULTS:
The two groups were comparable in terms of age, body mass index (BMI), prostate-specific antigen (PSA) values, Gleason score at biopsy, preoperative and pathological estimated prostate volumes. EBL was lower in the group1 (<0.001) and operative time was higher in the group1 (<0.001). No differences were found between the two groups in terms of postoperative blood loss, catheterization time, bladder neck contracture and positive margin.

CONCLUSIONS:
The bladder neck sparing technique of RALRP does not increase the percentage of positive margins at this anatomical location and can decrease the estimated blood loss.


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