Search

Objectives: A pre‐equipped metal trocar is required to use as a camera trocar due to a specification change in the da Vinci X/Xi system (Intuitive Surgical). We observed slight slippage of a trocar placed by the open method. With optical trocar access (OTA), the initial trocar is viewed directly with a laparoscope during placement. Reports regarding OTA for robotic surgery are limited, particularly for robot‐assisted radical prostatectomy (RARP). We modified the OTA procedure such that it was appropriate for RARP. Patients and Methods: A total of 158 patients were enrolled in this study. The first trocar placement time (FTPT) was compared between the open and OTA groups. In the OTA group, the trocar was mainly placed through the upper abdominal quadrant. We also analyzed the differences between the conventional and modified OTA procedures using the Kii Fios First Entry trocar (Applied Medical). We examined the factors affecting the FTPT using linear regression models. A P value <.05 was considered significant. Results: The FTPT was significantly shorter in the OTA group than the open group (P <.0001). The modified method was associated with a shorter FTPT (P =.0001). None of the patient characteristics affected the FTPT in either group. No major complications were observed. Conclusions: OTA was applied successfully during RARP. Use of the Kii Fios First Entry trocar with upper abdominal quadrant placement was suitable for RARP. [ABSTRACT FROM AUTHOR]

Background/aim: To examine the specific time frame and identify associated risk factors from commencement of hormonal therapy to the onset of castration-resistant prostate cancer among patients who have developed biochemical recurrence following radical prostatectomy., Patients and Methods: We retrospectively reviewed the records of 92 patients who developed biochemical recurrence and received hormonal therapy as initial salvage treatment after radical prostatectomy for high-risk localized prostate cancer from 2005 to 2021. The castration-resistant prostate cancer-free survival rates from the commencement of salvage hormonal therapy were analyzed using log-rank methods. Cox proportional hazard regression was performed to analyze the risk factors associated with acquiring castration resistance. The patients were stratified based on those risk factors., Results: During a median follow-up duration of 57 months, 24 (26.1%) patients developed castration-resistant prostate cancer. The 5- and 10-year castration-resistant prostate cancer-free survival rates were 73.6% and 54.5%, respectively. A multivariate analysis showed that Grade Group of 5 and prostate-specific antigen doubling time at biochemical recurrence of ≤3 months were independent predictors of castration-resistant prostate cancer. The 5-year castration-resistant prostate cancer-free survival rates in the low- and high-risk groups, stratified according to the aforementioned factors, were 85.4% and 47.6%, respectively., Conclusion: Patients in high Grade Group and short prostate-specific antigen doubling time after radical prostatectomy are more likely to develop resistance to salvage hormonal therapy., Competing Interests: The Authors have no conflicts of interest to disclose in relation to this study., (©2024 The Author(s). Published by the International Institute of Anticancer Research.)