ISSN 2149-3235 | E-ISSN 2149-3057
Original Article
The efficacy and utilisation of preoperative multiparametric magnetic resonance imaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan?
1 Department of Urology, İstanbul Bilim University School of Medicine, İstanbul, Turkey  
2 Department of Radiology, İstanbul Bilim University School of Medicine, İstanbul, Turkey  
Turk J Urol 2017; 43: 470-475
DOI: 10.5152/tud.2017.35589
Key Words: Dissection; magnetic resonance; prostate; prostatectomy
Abstract

Objective: We investigated the effect of the use of multiparametric prostate magnetic resonance imaging (mp-MRI) on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robot-assisted radical prostatectomy.

 

Material and methods: We prospectively evaluated 60 consecutive patients, including 30 patients who had (Group 1), and 30 patients who had not (Group 2) mp-MRI before robot-assisted radical prostatectomy. Based on the findings of mp-MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial in the mp-MRI group. Two groups were compared in terms of age, prostate-specific antigen (PSA), Gleason sum scores and surgical margin positivity.

 

Results: There was no statistically significant difference between the two groups in terms of age, PSA, biopsy Gleason score, final pathological Gleason score and surgical margin positivity. mp-MRI changed the initial surgical plan in 18 of 30 patients (60%) in Group 1. In seventeen of these patients (56%) surgical plan was changed from non-nerve sparing to interfascial nerve sparing plan. In one patient dissection plan was changed to non-nerve sparing technique which had extraprostatic extension on final pathology. Surgical margin positivity was similar in Groups 1, and 2 (16% and 13%, respectively) although, Group 1 had higher number of high- risk patients. mp-MRI confirmed the primary tumour localisation in the final pathology in 27 of of 30 patients (90%).

 

 

Conclusion: Preoperative mp-MRI effected the decision to perform a nerve-sparing technique in 56% of the patients in our study; moreover, changing the dissection plan from non-nerve-sparing technique to a nerve sparing technique did not increase the rate of surgical margin positivity.

 

 

Cite this article as: Tavukçu HH, Aytaç Ö, Balcı NC, Kulaksızoğlu H, Atuğ F. The efficacy and utilisation of preoperative multiparametric magnetic resonance ımaging in robot-assisted radical prostatectomy: does it change the surgical dissection plan? Turk J Urol 2017; 43(4): 470-5

Key Words
Authors
All
Survey
AVES | Copyright © 2018 Turkish Association of Urology | Latest Update: 13.06.2018