Robot-assisted radical prostatectomy with Retzius-Sparing approach vs. modified Frankfurt: comparison of results at 1 year of follow-up




Víctor E. Corona-Montes, Departamento de Urología y Cirugía Robótica, Centro Médico A.B.C. (American British Cowdray) Observatorio; Servicio de Urología, Hospital General de México Dr. Eduardo Liceaga; Centro de Cirugía Robótica, Hospital Ángeles del Pedregal; Centro de Cirugía Robótica, San Ángel Inn Universidad; Ciudad de México, México
Jorge L. Barzallo-Sánchez, Servicio de Urología Oncológica, Hospital General de México Dr. Eduardo Liceaga; Alta Especialidad en Cirugía Laparoscópica y Robótica, Universidad Nacional Autónoma de México; Ciudad de México, México
Juan E. Sánchez-Núñez, Servicio de Urología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Rocío N. Gómez-López, Departamento de Urología y Cirugía Robótica, Centro Médico A.B.C. (American British Cowdray) Observatorio, Ciudad de México, México
Adolfo Pérez-García, Departamento de Investigación, Hospital General de México Dr. Eduardo Liceaga. Ciudad de México, México


Background: Robot-assisted radical prostatectomy has positioned itself as the approach of choice in the treatment of prostate cancer. Objective: To compare the outcomes of robot-assisted radical prostatectomy using the Retzius-Sparing (RS) approach against the modified Frankfurt (MF) technique. Method: To describe the perioperative, functional and oncological outcomes of 13 patients with prostate cancer who underwent RS robotic radical prostatectomy compared to MF, evaluating pathological results, urinary continence, sexual function and oncological control in 1 year of follow-up. Results: The average age was 64 years in RS group vs. 61 years in MF group. The values of total prostate antigen were higher in the RS group (25 ng/dl) vs. MF group (11 ng/dl). The volume of gland in RS group was 40.62 ml vs. 63.33 ml in the RS group. All patients were bilat erally neuropreserved, being statistically significant in favor of MF group (p = 0.016). Positive surgical margins were higher in R-S group (38.4%) vs. MF group (33.3%). Conclusions: With RS the same tendency to urinary continence is observed, with a significant difference in erectile function in favor of MF. This preliminary study shows better impact on erectile function.



Keywords: Robot-assisted radical prostatectomy, Prostate cancer. Retzius-Sparing, Frankfurt-Modified. Robotic surgery.