Sotelo Rene, Clavijo Rafael, Carmona Oswaldo, Garcia Alejandro, Banda Eduardo, Miranda Marcelo, Fagin Randy
La Floresta Medical Institute, Caracas, Venezuela.
J Urol. 2008 Feb;179(2):513-5. doi: 10.1016/j.juro.2007.09.065.
Minimally invasive approaches for large, symptomatic benign prostatic hyperplasia are replacing the gold standard open surgical approach, duplicating its results with lower morbidity. We describe our initial experience with robotic simple prostatectomy.
Since January 2007, robotic simple prostatectomy was performed via a transperitoneal approach in 7 patients with symptomatic significant prostatomegaly on transrectal ultrasound (mean 77.66 gm). Demographic, perioperative and outcome data were recorded and all procedures were performed by the same surgeon.
Average patient age was 63.2 years (range 56 to 72) and estimated blood loss was 298 ml (range 60 to 800). Average operative time was 205 minutes (range 120 to 300). Average hospital stay was 1.4 days (range 1 to 2), average Foley catheter duration was 7 days (range 6 to 9) and drains were removed after an average of 3.75 days (range 3 to 4). Mean specimen weight on pathological examination was 50.48 gm (range 40 to 64.5). Transfusion was necessary in 1 patient. No complications were documented. Considerable improvement from baseline was noted in International Prostate Symptom Score (preoperative vs postoperative 22 vs 7.25) and maximum urine flow (preoperative vs postoperative 17.75 vs 55.5 ml per minute). Four patients were in acute urinary retention preoperatively.
Robotic simple prostatectomy is a feasible, reproducible procedure. Further publications are expected with larger series and larger prostatic adenomas.
对于有症状的大型良性前列腺增生，微创方法正在取代金标准的开放手术方法，以更低的发病率复制其疗效。我们描述了我们在机器人单纯前列腺切除术方面的初步经验。
自2007年1月起，对7例经直肠超声显示有症状且前列腺明显增大（平均77.66克）的患者经腹腔途径实施机器人单纯前列腺切除术。记录人口统计学、围手术期和结果数据，所有手术均由同一位外科医生进行。
患者平均年龄为63.2岁（范围56至72岁），估计失血量为298毫升（范围60至800毫升）。平均手术时间为205分钟（范围120至300分钟）。平均住院时间为1.4天（范围1至2天），平均留置导尿管时间为7天（范围6至9天），引流管平均在3.75天后拔除（范围3至4天）。病理检查时标本平均重量为50.48克（范围40至64.5克）。1例患者需要输血。未记录到并发症。国际前列腺症状评分（术前22分与术后7.25分）和最大尿流率（术前每分钟17.75毫升与术后每分钟55.5毫升）较基线有显著改善。4例患者术前处于急性尿潴留状态。
机器人单纯前列腺切除术是一种可行且可重复的手术。预计会有更多关于更大样本系列和更大前列腺腺瘤的报道发表。
