Academic & Research, Urology, Medanta Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon, Delhi, India.
BJU Int. 2011 Nov;108(9):1501-5. doi: 10.1111/j.1464-410X.2011.10113.x. Epub 2011 Mar 10.
• To critically analyze and compare surgical, oncological and functional outcomes of robot-assisted radical prostatectomy (RARP) in patients with and without previous transurethral resection of prostate (TURP).
• The study comprised 158 cases of RARP for clinically localized prostate cancer, including 26 cases that had undergone previous TURP (Group A). • Surgical, oncological and functional (short- and intermediate-term) outcomes of Group A were compared with 132 cases without previous TURP (Group B).
• Post TURP patients were found to have significantly greater blood loss (494 vs 324 mL) and a need for bladder neck reconstruction (26.7% vs 9.7%) compared to the non-TURP group. • Surgical time (189 vs 166 min), conversion rate, margin positivity rate and biochemical recurrence rate were also higher. • Incontinence rates were higher both at 6 (14% vs 11.8%) and 12 (25% vs 8%) months follow-up.
• RARP is feasible but challenging after TURP. It entails a longer operating time, greater operative difficulty and compromised oncological or continence outcomes. • These cases should be handled by an experienced robotic surgeon with the appropriate expertise.
本研究包括 158 例临床局限性前列腺癌的 RARP 病例，其中 26 例有 TURP 病史（A 组）。
将 A 组的手术、肿瘤学和功能（短期和中期）结果与 132 例无 TURP 病史的患者（B 组）进行比较。
与非 TURP 组相比，TURP 后患者的出血量（494 与 324ml）和需要进行膀胱颈重建的比例（26.7%与 9.7%）显著更高。
手术时间（189 与 166 分钟）、转换率、切缘阳性率和生化复发率也更高。
在 6 个月（14%与 11.8%）和 12 个月（25%与 8%）随访时，尿失禁的发生率也更高。
RARP 在 TURP 后是可行的，但具有挑战性。它需要更长的手术时间、更大的手术难度，并且肿瘤学或控尿结果受损。
这些病例应由经验丰富的机器人外科医生处理，并具备相应的专业知识。
