{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:19:46Z","timestamp":1789690786113,"version":"4.0.1"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,11,30]],"date-time":"2017-11-30T00:00:00Z","timestamp":1512000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2018,6]]},"abstract":"\n Objectives<\/jats:title>\n \n To evaluate the neurovascular structure\u2010adjacent frozen\u2010section examination (Neuro\n SAFE<\/jats:styled-content>\n ) technique in a British setting in men undergoing robot\u2010assisted laparoscopic radical prostatectomy (\n RALP<\/jats:styled-content>\n ) .\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n We retrospectively analysed our prospectively maintained database of patients who underwent\n RALP<\/jats:styled-content>\n between November 2008 and February 2017. We examined preoperative pathological and functional parameters, intraoperative nerve sparing (\n NS<\/jats:styled-content>\n ), postoperative histology, as well as functional and oncological follow\u2010up. We compared those who had a Neuro\n SAFE<\/jats:styled-content>\n approach and those who had\n NS<\/jats:styled-content>\n without Neuro\n SAFE<\/jats:styled-content>\n . We also compared all the\n RALP<\/jats:styled-content>\n s before and after the introduction of Neuro\n SAFE<\/jats:styled-content>\n . Statistical analysis was done using the two\u2010tailed\n t<\/jats:italic>\n \u2010test and chi\u2010squared analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This single surgeon series included 417\n RALP<\/jats:styled-content>\n s, including 120 Neuro\n SAFE<\/jats:styled-content>\n s. The Neuro\n SAFE<\/jats:styled-content>\n cohort had a greater proportion of D'Amico high\u2010risk disease (30.8% vs 9.6%,\n P<\/jats:italic>\n \u00a0< 0.001), higher Gleason scores and higher\n pT<\/jats:styled-content>\n stage compared to the non\u2010Neuro\n SAFE NS<\/jats:styled-content>\n cohort. After the introduction of Neuro\n SAFE<\/jats:styled-content>\n , more preoperatively potent men underwent bilateral\n NS<\/jats:styled-content>\n with\n pT<\/jats:styled-content>\n 2 disease (84.6% vs 66.3%,\n P<\/jats:italic>\n = 0.002) and more overall\n NS<\/jats:styled-content>\n were performed in patients with\n pT<\/jats:styled-content>\n 3 disease (65.1% vs 36.7%,\n P<\/jats:italic>\n = 0.012). Overall positive surgical margin (\n PSM<\/jats:styled-content>\n ) rates were lower in the Neuro\n SAFE<\/jats:styled-content>\n cohort compared to those who had\n NS<\/jats:styled-content>\n without Neuro\n SAFE<\/jats:styled-content>\n (9.2% vs 17.8%,\n P<\/jats:italic>\n = 0.04). The 12\u2010month potency rates were also higher in the Neuro\n SAFE<\/jats:styled-content>\n cohort for both bilateral (77.3% vs 50.9%,\n P<\/jats:italic>\n = 0.009) and unilateral (70.6% vs 40%,\n P<\/jats:italic>\n = 0.04)\n NS<\/jats:styled-content>\n . Pad\u2010free continence was also higher in the Neuro\n SAFE<\/jats:styled-content>\n group (85.7% vs 70.9%,\n P<\/jats:italic>\n = 0.019), but there was no significant difference between those who were wearing \u22641 safety pad. Although we only had short\u2010term oncological\u00a0follow\u2010up, it did not significantly differ between the two groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Adoption of Neuro\n SAFE<\/jats:styled-content>\n allowed us to offer\n NS<\/jats:styled-content>\n in higher risk patients, whilst reducing\n PSM<\/jats:styled-content>\n rates and at the same time improving potency at 12\u00a0months.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.14078","type":"journal-article","created":{"date-parts":[[2017,11,10]],"date-time":"2017-11-10T02:36:38Z","timestamp":1510281398000},"page":"854-862","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["The neurovascular structure\u2010adjacent frozen\u2010section examination (Neuro\n SAFE<\/scp>\n ) approach to nerve sparing in robot\u2010assisted laparoscopic radical prostatectomy in a British setting \u2013 a\u00a0prospective observational comparative study"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9055-1866","authenticated-orcid":false,"given":"George","family":"Mirmilstein","sequence":"first","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre at the Lister Hospital Stevenage Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavan Prasad","family":"Rai","sequence":"additional","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre at the Lister Hospital Stevenage Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olayinka","family":"Gbolahan","sequence":"additional","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre at the Lister Hospital Stevenage Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinaya","family":"Srirangam","sequence":"additional","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre at the Lister Hospital Stevenage Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Narula","sequence":"additional","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre at the Lister Hospital Stevenage Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samita","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre at the Lister Hospital Stevenage Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim M.","family":"Lane","sequence":"additional","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer Centre at the Lister Hospital Stevenage Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Vasdev","sequence":"additional","affiliation":[{"name":"Hertfordshire and Bedfordshire Urological Cancer 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