Ryu Jeman, Kwon Taekmin, Kyung Yoon Soo, Hong Sungwoo, You Dalsan, Jeong In Gab, Kim Choung-Soo
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Korean J Urol. 2013 Nov;54(11):756-61. doi: 10.4111/kju.2013.54.11.756. Epub 2013 Nov 6.
To compare the complications of radical retropubic prostatectomy (RRP) with those of robot-assisted laparoscopic prostatectomy (RALP) performed by a single surgeon for the treatment of prostate cancer.
The postoperative complications of 341 patients who underwent RRP and 524 patients who underwent RALP for prostate cancer at the Asan Medical Center between July 2007 and August 2012 were retrospectively reviewed and compared. Complications were classified according to the modified Clavien classification system.
RALP was associated with a shorter length of hospital stay (mean, 7.9 days vs. 10.1 days, p<0.001) and duration of urethral catheterization (6.2 days vs. 7.5 days, p<0.001) than RRP. Major complications (Clavien grade III-IV) were less common in the RALP group than in the RRP group (3.4% vs. 7.6%, p=0.006). There were no significant differences in medical complications between procedures. Considering surgical complications, urinary retention (7.0% vs. 2.7%, p=0.002) and wound repair (4.1% vs. 0.2%, p<0.001) were more common after RRP than after RALP. Extravasation of contrast medium during cystography was more common in the RRP group than in the RALP group (10.0% vs. 2.1%, p<0.001).
RALP is associated with a lower complication rate than RRP.
比较由同一位外科医生实施的耻骨后根治性前列腺切除术（RRP）与机器人辅助腹腔镜前列腺切除术（RALP）治疗前列腺癌的并发症。
回顾性分析并比较2007年7月至2012年8月在峨山医学中心接受RRP的341例患者和接受RALP的524例前列腺癌患者的术后并发症。并发症根据改良的Clavien分类系统进行分类。
与RRP相比，RALP的住院时间更短（平均7.9天对10.1天，p<0.001），导尿管留置时间更短（6.2天对7.5天，p<0.001）。RALP组的主要并发症（Clavien III-IV级）比RRP组少见（3.4%对7.6%，p=0.006）。两种手术的医疗并发症无显著差异。考虑手术并发症，RRP术后尿潴留（7.0%对2.7%，p=0.002）和伤口修复（4.1%对0.2%，p<0.001）比RALP更常见。膀胱造影时造影剂外渗在RRP组比RALP组更常见（10.0%对2.1%，p<0.001）。
RALP的并发症发生率低于RRP。
