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机器人辅助与单纯腹腔镜下根治性前列腺切除术

Robot-assisted versus pure laparoscopic radical prostatectomy.

作者信息

Rozet Francois, Harmon Justin, Cathelineau Xavier, Barret Eric, Vallancien Guy

机构信息

Department of Urology, Institut Montsouris, 42 bd Jourdan, 75014, Paris, France.

出版信息

World J Urol. 2006 Jun;24(2):171-9. doi: 10.1007/s00345-006-0065-3. Epub 2006 Mar 17.

Abstract

The aim of this study is to report the relative advantages and disadvantages of the radical prostatectomy with a laparoscopic (LRP) and a robotic (RALP) approach. A medline search was performed. Published data regarding perioperative parameters, complications, oncological results, functional results were analyzed. Shorter learning curves have been reported with the RALP. Intra-operative and post-operative outcomes appear to be comparable between the two approaches. The average time for LRP is 234 min (151-453) versus 182 min (141-250) for RALP. Estimated blood loss for the LRP averages 482 ml (185-850) versus 234 ml (75-500) for the RALP. Complication rates in single institution studies are similar. Long-term outcomes data on PSA progression is not yet available for LRP or RALP due to their relatively short existence. RALP appears to offer a significant benefit to the laparoscopically naïve surgeon with respect to learning curve when compared to LRP. This, however, comes at an increased cost. Intra-operative and post-operative outcomes appear to be similar. Longer follow-up data is necessary to compare oncological and functional outcomes.

摘要

本研究的目的是报告腹腔镜根治性前列腺切除术(LRP)和机器人辅助根治性前列腺切除术(RALP)的相对优缺点。进行了Medline检索。分析了关于围手术期参数、并发症、肿瘤学结果、功能结果的已发表数据。据报道,RALP的学习曲线较短。两种手术方式的术中及术后结果似乎具有可比性。LRP的平均手术时间为234分钟(151 - 453分钟),而RALP为182分钟(141 - 250分钟)。LRP的估计失血量平均为482毫升(185 - 850毫升),而RALP为234毫升(75 - 500毫升)。单机构研究中的并发症发生率相似。由于LRP和RALP应用时间相对较短,目前尚无关于其PSA进展的长期结果数据。与LRP相比,RALP对于初次接触腹腔镜手术的外科医生而言,在学习曲线上似乎具有显著优势。然而,这会带来成本的增加。术中及术后结果似乎相似。需要更长时间的随访数据来比较肿瘤学和功能结果。

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