Introduction&Objective:

To evaluate functional outcomes and positive margin positive rates (PSMR) for intra-operative frozen section (IOFS) analysis of the prostate during RARP allowing nerve sparing.

Methods:          

We prospectively analysed the data of 100 patients who underwent an IOFS during RARP from November 2012 to November 2015. Our IOFS technique involved whole lateral circumferential analysis of the prostate with the corresponding neurovascular tissue. Intrafascial nerve spare was performed. The specimen was removed intra-operatively by extension of the 12mm-camera port. Proportion were compared using the 2-tailed z-test (p-value<0.05=significant).

 Results:

Median time to extract the specimen, wound closure and re-establishment of pneumoperitoneum  increased the operative time by 8 min. Median blood loss for IOFS vs. non-IOFS cohort was 130±97 ml vs 90±72 ml (p=NS) respectively. For T2 disease the proportion of patients who underwent a nerve sparing approach (unilateral or bilateral) in IOFS and non-IOFS cohort was 62% vs. 98.7% (p<0.05). For T3 disease the proportion of patients who underwent a nerve sparing approach (unilateral or bilateral) in IOFS and non-IOFS cohort was 28% vs. 91% (p<0.05). The 3 and 12-month continence rates for IOFS vs. non-IOFS cohort was 81% vs. 78%, p=NS and 93% vs.95%, p=NS respectively. The 12-month erectile function rates for IOFS vs. non-IOFS cohort was 31.74 vs.64%, p-0.0001. For T2 disease PSMR were T2-6.4% vs. 16.7% (p=0.02). For T3 Disease PSMR were 9% vs. 44% (p=0.002).

Conclusion: Introduction of the IOFS analysis increased the proportion of patients undergoing a nerve sparing approach, decreased the PSMR and improved erectile function rates