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Rath, Lukas; Jokisch, Friedrich; Schulz, Gerald Bastian; Kretschmer, Alexander; Buchner, Alexander; Stief, Christian G. and Weinhold, Philipp (2021): Combined Open Prostatectomy and Kidney Surgery: Feasibility and 12-Month Outcome. In: Research and Reports in Urology, Vol. 13: pp. 815-821

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Purpose: There are only a few case reports and case series that investigated combined laparoscopic or robotic surgery for simultaneous prostate and kidney cancer. In this study, we want to close a gap in existing research to assess the feasibility and oncological outcome of combined open prostatectomy and kidney surgery. Methods: We retrospectively analyzed patients who underwent a combined open prostatectomy and either a partial or complete nephrectomy from 2013 to 2020. Descriptive statistics were used to assess perioperative parameters and the 12-month functional and oncological outcomes after combined surgery. Results: We identified 10 patients undergoing combined open surgery. Partial nephrectomy was performed in 4, radical nephrectomy in 6 patients. For prostate cancer, histopathological analysis showed a tumor stage >= pT2c in all 10 patients. For renal tumors, histopathological analysis showed clear cell renal cell carcinoma in 8 patients and oncocytoma in 2 patients. Operating time was 177 +/- 36 minutes. Two perioperative complications (Clavien 2a and 3) were observed. Three months postoperatively, the International Index of Erectile Function (IIEF-5) score was 5.6 +/- 5.9, the ICIQ-SF score was 7.3 +/- 5.6 and were using 1.9 +/- 2.2 pads per day. This improved after 12 months postoperatively, as patients had an IIEF-5 score of 6.33 +/- 6.5, an ICIQ-SF score of 4.4 +/- 5.7 and were using pads 0.9 +/- 1.7 per day. Conclusion: In this study, we showed that open surgery is a safe and valid approach for combined prostatectomy and renal surgery with acceptable complications and oncological outcomes. The combined open approach could be a good alternative to combined laparoscopic/robotic surgery in this field, especially to treat patients with advanced renal tumors or previous abdominal surgery or radiation.

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