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机器人辅助与开放性根治性前列腺切除术治疗局限性前列腺癌患者的短期疗效比较。

Short-term outcome of patients with robot-assisted versus open radical prostatectomy: for localised carcinoma of prostate.

机构信息

Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

出版信息

Hong Kong Med J. 2010 Feb;16(1):31-5.

Abstract

OBJECTIVE

To compare the short-term outcome of patients undergoing robot-assisted versus open radical prostatectomy.

DESIGN

Retrospective analysis of prospectively collected data.

SETTING

A university teaching hospital in Hong Kong.

PATIENTS

Twenty consecutive cases having robot-assisted radical prostatectomy were compared with the last 20 cases of open radical prostatectomy (prior to November 2005 when the robotic system was introduced).

MAIN OUTCOME MEASURES

Perioperative functional evaluation (with special emphasis on continence) and oncological evaluation (included margin studies and prostate-specific antigen levels).

RESULTS

Regarding baseline clinical characteristics of the patients, there was no statistically significant difference between the robotic and open radical prostatectomy groups. For perioperative outcome, in the robotic group the blood transfusion rate was significantly lower (5 vs 65%), hospital stay was shorter (8 vs 17 days), and the catheter time was shorter (12 vs 18 days). For early oncological outcome, there was no statistically significant difference in the margin positive rate and early prostate-specific antigen results. Regarding continence (use of 0-1 pads/day), it was achieved by 95% in the robotic group with a mean follow-up of 6 months compared to 85% in the open group with a mean follow-up of 42 months.

CONCLUSIONS

Robot-assisted radical prostatectomy offered the benefits of a minimally invasive operation with less blood loss, shorter catheter time and hospital stay, and earlier continence. It has therefore become the preferred surgical option in our institution.

摘要

目的

比较机器人辅助与开放性根治性前列腺切除术患者的短期疗效。

设计

前瞻性收集数据的回顾性分析。

地点

中国香港一家大学教学医院。

患者

20 例行机器人辅助根治性前列腺切除术患者与 20 例行开放性根治性前列腺切除术(2005 年 11 月机器人系统引入前)的患者相比较。

主要观察指标

围手术期功能评估(特别强调尿控)和肿瘤学评估(包括切缘研究和前列腺特异性抗原水平)。

结果

两组患者的基线临床特征无统计学差异。在机器人组,术中输血率显著降低(5%对 65%),住院时间缩短(8 天对 17 天),导尿管留置时间缩短(12 天对 18 天)。在早期肿瘤学结果方面,两组的切缘阳性率和早期前列腺特异性抗原结果无统计学差异。在尿控(每天使用 0-1 个尿垫)方面,机器人组 95%的患者达到了这一目标,中位随访时间为 6 个月,而开放性组 85%的患者达到了这一目标,中位随访时间为 42 个月。

结论

机器人辅助根治性前列腺切除术具有微创操作、术中出血少、导尿管留置时间和住院时间短、尿控更早恢复的优势。因此,它已成为我们机构的首选手术方式。

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