Rozet Francois, Harmon Justin, Cathelineau Xavier, Barret Eric, Vallancien Guy
Department of Urology, Institut Montsouris, 42 bd Jourdan, 75014, Paris, France.
World J Urol. 2006 Jun;24(2):171-9. doi: 10.1007/s00345-006-0065-3. Epub 2006 Mar 17.
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.
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。