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Pharmacologic alternatives to blood
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
The results have been published of another randomized non-placebo-controlled non-blinded trial of two EPO regimens (600 u/kg versus 300 u/kg) administered on preoperative days 14 and 7 in 200 men undergoing radical retropubic prostatectomy.28 The mean increases in hematocrit (%) were 4.5 and 4.7, respectively, and the allogeneic exposure rates were 6% and 7%, respectively. These allogeneic exposure rates are comparable to the 9% seen with predonation of three autologous blood units in a previous study by the same group. The calculated EPO costs per patient were $1218 and $656, respectively, which the authors feel may be justified if patient time and loss of work for autologous blood donation (as the alternative) is taken into account.
Anesthesia for Urogenital Surgery
Published in Kevin R. Loughlin, Complications of Urologic Surgery and Practice, 2007
Linda S. Aglio, James A. Street, Paul D. Allen
Radical surgery in urology is becoming common. Procedures include radical nephrectomy, radical retropubic prostatectomy, and radical cystectomy. These surgeries have some common features. There may be sudden and significant blood loss, with preservation of renal function becoming an important consideration.
Malignant Neoplasms of the Colon
Published in Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens, Neoplasms of the Colon, Rectum, and Anus, 2007
In the unique situation in which there is isolated invasion of the prostate by a rectal carcinoma, Campbell et al. (538) described the use of radical retropubic prostatectomy in conjunction with restorative proctosigmoidectomy for en bloc excision. This novel technique offers an alternative to total pelvic exenteration, thereby obviating the need for urinary and fecal diversion. The expected 5-year survival of patients subjected to en bloc resection ranged from 30% to 79% (see Table 8) and thus justifies an aggressive approach.
Randomized, Placebo-Controlled Six-Month Intervention Study of Soy Protein Isolate in Men with Biochemical Recurrence after Radical Prostatectomy: A Pilot Study
Published in Nutrition and Cancer, 2022
Maarten C. Bosland, Joanne Schmoll, Hiroko Watanabe, Carla Randolph, Ikuko Kato
Prostate-specific antigen (PSA) is a serine protease member of the kallikrein-related peptidase family. It is produced by human prostatic epithelial cells and is secreted in the semen. It can leak into the blood stream in disease conditions of the prostate, prostatitis, benign prostate hypertrophy (BPH), and prostate cancer. It is measured in the blood for early detection of prostate cancer and to monitor efficacy of treatments for this malignancy. Treatments of early stage prostate cancer, radical retropubic prostatectomy, and various radiation modalities, typically have curative intent. When local recurrence occurs or distant metastases have developed, PSA levels in the blood will start rising from the low to undetectable levels immediately following the initial treatment. Various approaches to deprive the cancer cells from androgenic stimuli and/or chemotherapy or salvage radiation treatment are then used as further therapeutic approaches, all with more or less severe side effects.
Correlation of the Grade Group of Prostate Cancer according to the International Society of Urological Pathology (Isup) 2014 Classification between Prostate Biopsy and Radical Prostatectomy Specimens
Published in Cancer Investigation, 2021
Serkan Akan, Caner Ediz, M. Cihan Temel, Ferhat Ates, Omer Yilmaz
Open radical retropubic prostatectomy was performed in all patients with the patient in dorsal decubitus and Trendelenburg position. After routine lower midline incision, endopelvic fascia was opened and the puboprostatic ligaments were divided. The dorsal venous complex was controlled and the urethra was exposed meticulously. We used the electrocautery minimally in these steps in order to protect the nerves and the erectile function. The prostate was dissected from the rectum posteriorly with blunt and sharp dissection. The seminal vesicles and the ejaculatory ducts were identified. The lateral prostate pedicles were ligated separately with 2/0 Vicryl sutures. The bladder neck was opened near the prostate tissue and the prostate was resected. Bladder neck was reconstructed if needed. The urethrovesical anastomosis was constructed with a Foley catheter placed and the catheter was removed on the postoperative day 14.
Quality of life assessment using EORTC QLQ questionnaires in the prostate cancer population treated with radical prostatectomy: a systematic review
Published in Scandinavian Journal of Urology, 2021
The studies included in this review all used the EORTC QLQ questionnaires as a concept. Of these, six were from Europe and were conducted in four different countries, and the remaining two were from Asia. One of the studies had a clinical trial design, while the other seven had a cohort design, with a total of 1936 patients. The most frequent follow-up time for assessment of quality of life after radical prostatectomy was one year post-surgery or earlier [14–20], but study evaluated the cohort only once after surgery (i.e. at 6 months) [21]. The mean age of patients in the the majority of the studies was over the age of 60. The clinical stage of tumor in the patients, where such information was included, was similar: cT1-cT2 [15,16,20], cT1-cT3 [14,18], However, one of the studies evaluated a group of patients at the cT2-cT3 stage of tumor. The most commonly used surgical technique was radical retropubic prostatectomy (RRP), while laparoscopic radical prostatectomy (LRP) was the rarest technique used in this review. Characteristics and summaries of the studies included in the qualitative synthesis are shown in Table 2.