Thiel David D, Hutchinson Ryan, Diehl Nancy, Tavlarides Andrea, Williams Adrienne, Parker Alexander S
Department of Urology, Mayo Clinic, Jacksonville, Florida 32224, USA
JSLS. 2012 Apr-Jun;16(2):195-201. doi: 10.4293/108680812x13291597717220.
We examined 1-year functional and oncologic outcomes for robotic-assisted laparoscopic prostatectomy (RALP) from a single surgeon entering practice directly from fellowship training.
We prospectively analyzed the first 100 RALPs performed by one fellowship-trained robotic surgeon. Data included resident involvement during the procedure, perioperative data, and surgical complications (scored using the Clavien grading system). Health-related quality of life (HRQOL) data were captured using the EPIC questionnaire at baseline (prior to surgery) and at 1-year follow-up.
Eighty-two patients (82%) had hospital stays of 2 days or less without any postoperative complications, urethral catheter removal was within 14 days of surgery, and none required readmission to the hospital. The overall positive margin rate was 21% (19% for patients with T2 disease). Clavien grades 1 through 4 complication rates, respectively, were 4%, 10%, 1%, and 1%. There were no deaths, reoperations, or bladder neck contractures. One patient (1%) required a blood transfusion within the 90-day perioperative period. At 1-year follow-up, 78% of patients reported wearing no pads; 41.3% of patients with baseline and 1-year follow-up data reported having intercourse.
We provide baseline data pertaining to the morbidity, oncologic efficacy, continence results, and potency outcomes of new surgeons performing RALP.
我们研究了一名刚结束 fellowship 培训后直接执业的外科医生实施的机器人辅助腹腔镜前列腺切除术（RALP）的 1 年功能和肿瘤学结局。
我们前瞻性分析了该名接受过 fellowship 培训的机器人外科医生实施的前 100 例 RALP。数据包括手术过程中住院医生的参与情况、围手术期数据以及手术并发症（使用 Clavien 分级系统评分）。使用 EPIC 问卷在基线（手术前）和 1 年随访时收集与健康相关的生活质量（HRQOL）数据。
82 例患者（82%）住院时间为 2 天或更短，无任何术后并发症，导尿管在手术后 14 天内拔除，且无人需要再次入院。总体切缘阳性率为 21%（T2 期疾病患者为 19%）。Clavien 1 至 4 级并发症发生率分别为 4%、10%、1%和 1%。无死亡、再次手术或膀胱颈挛缩发生。一名患者（1%）在 90 天围手术期内需要输血。在 1 年随访时，78%的患者报告无需使用护垫；有基线和 1 年随访数据的患者中，41.3%报告有性生活。
我们提供了有关新外科医生实施 RALP 的发病率、肿瘤学疗效、控尿结果和性功能结局的基线数据。
