Robot-Assisted Radical Prostatectomy in a Post−Kidney Transplant Patient: An Initial Case Report in China

• Published in: Transplantation proceedings Vol. 50; no. 10; pp. 3978 - 3983
• Main Authors: Fang, Y., Chen, Z., Juan, L., Feng, Z., Cao, J., Zhou, B., Huang, Y., Cen, J., Lu, J., Liang, Y., Wei, J., Luo, J., Chen, W.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2018
• Subjects: China; Humans; Kidney Transplantation; Male; Middle Aged; Postoperative Complications; Prostate-Specific Antigen - blood; Prostatectomy - instrumentation; Prostatectomy - methods; Prostatic Neoplasms - complications; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Robotic Surgical Procedures - instrumentation; Robotic Surgical Procedures - methods; Transplantation, Homologous; China
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2018.09.015

Our aim was to evaluate the general applicability, feasibility, and safety of robot-assisted radical prostatectomy (RARP) in Chinese renal allograft patients for prostate cancer removal. A 62-year-old patient diagnosed as having biopsy-proven localized prostate cancer in March 2016 who had undergone renal transplant 12 years ago was studied. The preoperative prostate-specific antigen value was determined to be 11.82 ng/mL and the Gleason score was determined to be 3 + 3. The RARP was carried out using a transperitoneal and posterior approach with 5 ports in May 2016. The most important technique was ensuring that the transplanted kidney and ureter remained untouched during the surgery. Only the right obturator lymph nodes were dissected because the renal allograft was overlying the iliac vessels. The RARP was successfully concluded following 230 minutes with an estimated blood loss of 200 mL. There were no postoperative complications. Final pathology was T2cN0M0, Gleason 3 + 3. Following catheter removal, the patient was completely continent and was discharged with no change in serum creatinine or glomerular filtration rate levels. During a 21-month follow-up, unobstructed urination, no incontinence, no biochemical recurrence, and normal kidney function were observed. RARP in Chinese renal allograft patients is a feasible method that can be accomplished with no injuries to the transplanted kidney or ureter and is achieved with favorable oncological and functional outcomes. In addition, post−kidney transplant male patients are recommended to have routine prostate-specific antigen screening for the early detection of prostate cancer. •Robot-assisted radical prostatectomy in renal allograft patient is feasible and can be accomplished with no injury of the transplanted kidney as well as achieved with favorable oncological and functional outcome.•The post−kidney transplant male patients should have routine prostate-specific antigen screening for early detection of prostate cancer.•Our study is the first on robot-assisted radical prostatectomy in Chinese renal allograft patients.