Dasgupta Prokar, Kirby Roger S
Guy's and St. Thomas' Hospitals, King's College London School of Medicine, London, UK.
Int J Urol. 2009 Mar;16(3):244-8. doi: 10.1111/j.1442-2042.2008.02232.x. Epub 2009 Jan 20.
Robot-assisted radical prostatectomy (RARP) is a rapidly evolving technique for the treatment of localized prostate cancer. However, cynics point to the increasing role of market forces in the robotic revolution. As yet, Europe has not taken up RARP in large numbers and this may in part relate to the high level of expertise in laparoscopy previously gained. Furthermore, setting up a robotic program is a major undertaking for many surgical units. This article reviews the current literature on RARP with regard to oncologic, continence and potency outcomes - the so called 'trifecta'. Preliminary data appears to show an advantage of RARP over open prostatectomy with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most intra-institutional studies demonstrate good postoperative continence and potency with RARP; however this needs to be viewed in the context of a paucity of randomized data available in the literature. There is no definitive data to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging.
机器人辅助根治性前列腺切除术（RARP）是一种用于治疗局限性前列腺癌的快速发展的技术。然而，怀疑论者指出市场力量在机器人革命中发挥着越来越大的作用。到目前为止，欧洲尚未大量采用RARP，这可能部分与之前获得的高水平腹腔镜技术专长有关。此外，对于许多外科单位来说，建立一个机器人手术项目是一项重大任务。本文回顾了目前关于RARP在肿瘤学、控尿和性功能方面结果的文献——即所谓的“三连胜”。初步数据似乎显示RARP相对于开放性前列腺切除术具有优势，包括失血减少、疼痛减轻、早期活动、住院时间缩短和切缘阳性率降低。大多数机构内部研究表明RARP术后控尿和性功能良好；然而，鉴于文献中缺乏随机数据，需要从这一背景来看待这一情况。没有确凿数据表明RARP优于标准腹腔镜手术，但该技术在5年内已与腹腔镜手术达到同等水平这一事实令人鼓舞。
