Rohner S, Bolle J F, Reverdin N, Tuchschmid Y
Rev Med Suisse. 2005 Nov 23;1(42):2748-54.
Radical prostatectomy remains the gold standard for treatment of localised prostate cancer. Standardisation of the open retro-pubic anatomic prostatectomy by P Walsh allows skilled but not expert surgeons to achieve a high standard of performance. Learning curve is short with this technic, with minor morbidity. Rates of incontinence are low and impotency is now rather uncommon in the younger patient while oncological control is optimal for histologicaly organ confined cancer. "Mini invasive technics", laparoscopy and robot-assisted laparoscopy, have a longer learning curve, including a higher rate of complications that are unusual with open surgery. Operating time remains longer, costs are superior to the open technic and oncological control is not yet clearly validated while rates of classical late complications are not lower. Consequently, most urologist still prefer the open approach
根治性前列腺切除术仍然是局限性前列腺癌治疗的金标准。P·沃尔什对耻骨后开放式解剖性前列腺切除术的标准化，使技术熟练但并非专家级的外科医生也能达到较高的手术水平。采用这种技术学习曲线短，并发症少。尿失禁发生率低，年轻患者中阳痿现在也相当少见，而对于组织学上局限于器官的癌症，肿瘤学控制是最佳的。“微创技术”，即腹腔镜手术和机器人辅助腹腔镜手术，学习曲线更长，包括并发症发生率更高，而这些并发症在开放手术中并不常见。手术时间仍然较长，成本高于开放技术，肿瘤学控制尚未得到明确验证，而经典晚期并发症的发生率也不低。因此，大多数泌尿外科医生仍然更喜欢开放手术方式
