Prostate MR imaging may be useful for helping sur¬geons plan the extent and side of nerve sparing during robotic-assisted laparoscopic prostatectomy (RALP), according to new research.
In the study, Timothy D. McClure, M.D., of the David Geffen School of Medicine at the University of California Los Angeles, and colleagues investigated endorectal coil MR imaging as a way to improve preoperative assessment of prostate cancer and the involvement of the neurovascular bundles.
Researchers prospectively evaluated 104 prostate cancer patients who underwent preoperative endorectal coil MR imaging of the prostate and subsequent RALP. They determined the differences in the surgical plan before and after review of the MR imaging report and compared them with the actual surgical and pathologic results.
Results showed that preoperative prostate MR imaging data changed the decision to use a nerve-sparing technique during RALP in 28 (27 percent) of the 104 patients. The surgical plan was changed to the nerve-sparing technique in 17 (61 percent) of the 28 patients and to a non-nerve-sparing technique in 11 patients (39 percent). The decision to opt for nerve-sparing surgery did not compromise oncologic outcome.
"Some patients thought to require non–nerve-sparing surgery might safely undergo nerve-sparing surgery on the basis of MR imaging findings because this change in surgical plan does not appear to be associated with an increase in positive surgical margins," according to researchers.
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