Evidence map›Paper›PMID 34384621›Full record

ArticleEuropean urology2022

Retrospective Concomitant Nonrandomized Comparison of "Touch" Cautery Versus Athermal Dissection of the Prostatic Vascular Pedicles and Neurovascular Bundles During Robot-assisted Radical Prostatectomy.

Martin Hofmann, Erica Huang, Linda My Huynh, Kamaljot Kaler, Simone Vernez, Adam Gordon, Blanca Morales, Douglas Skarecky, Thomas E Ahlering

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Article in European urology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Martin HofmannDepartment of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Urology, University of California, Irvine, CA, USA.
Erica HuangDepartment of Urology, University of California, Irvine, CA, USA.
Linda My HuynhDepartment of Urology, University of California, Irvine, CA, USA; MD/PhD Scholars Program, University of Nebraska Medical Center, Omaha, NE, USA.
Kamaljot KalerDepartment of Surgery, Section of Urology, University of Calgary, Alberta, Canada.
Simone VernezDepartment of Urology, University of California, Irvine, CA, USA.
Adam GordonDepartment of Urology, University of California, Irvine, CA, USA.
Blanca MoralesDepartment of Urology, University of California, Irvine, CA, USA; University of California, San Francisco.
Douglas SkareckyDepartment of Urology, University of California, Irvine, CA, USA.
Thomas E AhleringDepartment of Urology, University of California, Irvine, CA, USA. Electronic address: tahlerin@uci.edu.
University of California, Irvine · USCleveland Clinic · USUniversity of Calgary · CAUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring robotic-assisted radical prostatectomy (RARP), the use of electrocautery near the neurovascular bundles (NVBs) frequently results in thermal injury to the cavernous nerves. The cut and "touch" monopolar cautery technique has been suggested to reduce desiccating thermal injury caused by bipolar energy when vessels are sealed.

objectiveTo compare potency outcomes between an athermal technique (AT) and touch cautery (TC) to transect the prostatic vascular pedicles (PVPs) and dissect the NVBs. DESIGN, SETTING, AND

participantsA retrospective concomitant nonrandomized study of AT versus TC was performed in 733 men. A total of 323 undergoing AT had "thin" pedicles, easily suitable for suture ligation. TC was based on "thick" pedicles (n = 230) difficult to suture ligate. Men were excluded for an International Index of Erectile Function (IIEF-5) score of <15 or adjuvant therapies (n = 180). SURGICAL PROCEDURE: Single-surgeon RARP. MEASUREMENTS: Patient-reported outcomes with erectile function (EF) recovery defined as two affirmative answers to erections sufficient for intercourse (ESI; "are erections firm enough for penetration?" and "are the erections satisfactory?"), IIEF-5 scores 15-25, and a novel percent fullness score comparing pre- versus postoperative erection fullness. Logistic regression models assessed the correlation between cautery technique, covariates, and EF recovery. RESULTS AND LIMITATIONS: In an unadjusted analysis, preoperative IIEF-5, age, body mass index (BMI), and prostate weight were significant predictors of potency recovery. Follow-up was similar (AT 52.7 mo vs TC 54.6 mo, p = 0.534). In logistic regression, preoperative IIEF-5, age, and BMI were significant predictors of EF recovery, defined as IIEF-5 scores 15-25, ESI, and percent fullness >75%. Results were similar when IIEF-5 and percent fullness were assessed continuously.

conclusionsDuring transection of the PVPs and dissection of the NVBs, TC did not impact EF recovery significantly, compared with an AT. PATIENT SUMMARY: Electrocautery can be applied safely, with similar outcomes to those of an athermal technique.

Indexed as

Erectile DysfunctionProstatic NeoplasmsRoboticsRobotic Surgical ProceduresCauteryElectrocoagulationHumansMalePenile ErectionProstateProstatectomyRecovery of FunctionRetrospective StudiesTouchTreatment OutcomeNerve sparingProstate cancerRobotic prostatectomyThermal injury

Identifiers

PMID34384621
OpenAlexW3190656951

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.