RT Journal Article SR Electronic T1 Safety and Outcomes of Intraoperative Ventriculoperitoneal Shunt Clamping During Robotic-assisted Radical Prostatectomy: Retrospective Cohort Analysis JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 1281 OP 1289 DO 10.21873/anticanres.17515 VO 45 IS 3 A1 HSU, JHE-YUAN A1 OU, HSIEN-CHE A1 OU, YEN-CHUAN A1 LIN, YI-SHENG A1 HUANG, LI-HUA A1 WENG, WEI-CHUN A1 HSU, CHAO-YU A1 TUNG, MIN-CHE YR 2025 UL http://ar.iiarjournals.org/content/45/3/1281.abstract AB Background/Aim: This study aimed to assess the safety and outcomes of intraoperative ventriculoperitoneal (VP) shunt clamping during robotic-assisted radical prostatectomy (RaRP) in patients with VP shunts.Patients and Methods: A retrospective analysis of nine patients with VP shunts who underwent RaRP between February 2016 and October 2024 was conducted. Data on preoperative prostate-specific antigen (PSA) levels, surgical margins, complications, and follow-up durations were collected. Patients were stratified into subgroups based on PSA levels (≤10 vs. >10 ng/ml), operative time (<200 vs. ≥200 min), and estimated blood loss (<150 vs. ≥150 ml). Outcomes were analyzed using descriptive statistics, focusing on PSA trends, biochemical recurrence, and VP shunt functionality.Results: All procedures were completed without intraoperative or VP shunt-related complications. The median operative time was 180 min (range=180-330 min), and the median estimated blood loss was 170 ml (range=50-700 ml). Most patients showed significant PSA suppression, with a median PSA of <0.008 ng/ml at one year. Patients with initial PSA levels >10 ng/ml had greater variability in PSA trends, including persistent elevation or biochemical recurrence, whereas those with PSA levels ≤10 ng/ml had stable outcomes. No differences in oncological outcomes were noted based on operative time or blood loss. Median follow-up was 54 months (range=2-105 months).Conclusion: VP shunt clamping during RaRP is safe and effective, with favorable surgical and oncological outcomes and preserved shunt functionality. Larger studies are needed to confirm these findings and establish standardized protocols.