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机器人辅助腹腔镜根治性前列腺切除术(RALP)——一种治疗前列腺癌的新手术方法。

Robot-assisted laparoscopic radical prostatectomy (RALP)--a new surgical treatment for cancer of the prostate.

作者信息

Wilson Liam C, Pickford Joanna E, Gilling Peter J

机构信息

Department of Urology, Bay of Plenty Clinical School, Tauranga Hospital, Tauranga, New Zealand.

出版信息

N Z Med J. 2008 Dec 12;121(1287):32-8.

Abstract

AIM

To examine the safety and efficacy of robotic-assisted laparoscopic prostatectomy (RALP) in the early cases of this new technique from a single institution.

METHOD

A prospective database was created to monitor perioperative and postoperative outcomes of men undergoing RALP for clinically localised carcinoma of the prostate.

RESULTS

The first 30 consecutive cases were followed prospectively. There were no conversions to open surgery, perioperative transfusions, re-operations, or major complications. The mean operating time was 280 minutes, with reductions in time between cases 1-10 and 10-20, and a smaller improvement between cases 10-20 and 20-30. The mean hospital stay was 1.4 days. There was one delayed discharge (4 days) due to an acute anxiety event. One patient required readmission for severe bladder spasm, and one patient had a failed trial of removal of catheter requiring re-catheterisation. One patient had a minor wound infection. The majority of patients had moderately-well differentiated, organ-confined disease on specimen histology.

CONCLUSION

The early results suggest that RALP is a safe and oncologically effective procedure. The local results are at least comparable with other early series in the literature. It is an important addition to the armamentarium available for treating prostate cancer in New Zealand.

摘要

目的

从单一机构研究机器人辅助腹腔镜前列腺切除术(RALP)在这项新技术早期病例中的安全性和有效性。

方法

创建一个前瞻性数据库,以监测接受RALP治疗临床局限性前列腺癌男性患者的围手术期和术后结果。

结果

对连续的前30例病例进行前瞻性随访。没有转为开放手术、围手术期输血、再次手术或重大并发症。平均手术时间为280分钟,病例1 - 10与10 - 20之间时间有所缩短,10 - 20与20 - 30之间改善较小。平均住院时间为1.4天。有1例因急性焦虑事件延迟出院(4天)。1例患者因严重膀胱痉挛需再次入院,1例患者拔管试验失败需重新插管。1例患者有轻微伤口感染。大多数患者标本组织学显示为中度分化良好、局限于器官的疾病。

结论

早期结果表明RALP是一种安全且在肿瘤学上有效的手术。局部结果至少与文献中其他早期系列相当。它是新西兰可用于治疗前列腺癌的手段中的一项重要补充。

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