Schurtz Elleson A, Markes Jhanelle, Newton Mark R, Brown James A
University of Iowa, Department of Urology, Iowa City, Iowa, USA.
Curr Urol. 2013 Feb;7(3):145-8. doi: 10.1159/000356267. Epub 2014 Feb 10.
Robotic laparoscopic assisted prostatectomy (RALP) has become the predominant technique for prostatectomy despite significant expense and no robust evidence supporting better cancer control, erectile function, or continence. Several studies have demonstrated lower bladder neck contracture (BNC) rates with RALP, believed to be related to improved visualization and control of the urethrovesical anastomosis. We evaluated the Capio™ radical prostatectomy (RP) suture capturing device for improving anastomotic precision during urethrovesical anastomosis in open radical prostatectomy.
We performed a retrospective review on a single-surgeon series of 50 consecutive patients undergoing radical retropubic prostatectomy (RRP) with utilization of the Capio™ RP device at an academic hospital (February 2010 to May 2012). Patient demographics, pathology, and outcomes data including rates of anastomotic leak, BNC, erectile function, and continence were collected.
Mean age of patients at the time of procedure was 60.4 ± 6.43 years. Patients were stratifed by D'Amico criteria into low (14.3%), intermediate (67.4%), and high (18.4%) risk groups. Mean follow-up for all patients was 13.1 ± 7.29 months. No patients were diagnosed with BNC within 90 days after surgery. Two patients (4%) were subsequently diagnosed and treated for BNC, one of whom was asymptomatic prior to diagnosis.
Utilizing the Capio™ RP device during RRP, we were able to achieve a BNC rate equivalent to rates reported for RALP. Use of the Capio™ RP device appears to be a cost-effective method for improving RRP urethrovesical anastomotic results.
机器人腹腔镜辅助前列腺切除术(RALP)已成为前列腺切除术的主要技术,尽管费用高昂且没有有力证据支持其在癌症控制、勃起功能或控尿方面有更好的效果。多项研究表明,RALP术后膀胱颈挛缩(BNC)发生率较低,这被认为与改善尿道膀胱吻合术的视野和控制有关。我们评估了Capio™根治性前列腺切除术(RP)缝线捕捉装置在开放性根治性前列腺切除术中改善尿道膀胱吻合术吻合精度的效果。
我们对一家学术医院(2010年2月至2012年5月)一位外科医生连续进行的50例使用Capio™ RP装置的耻骨后根治性前列腺切除术(RRP)患者进行了回顾性研究。收集了患者的人口统计学、病理学和结局数据,包括吻合口漏、BNC、勃起功能和控尿率。
手术时患者的平均年龄为60.4±6.43岁。根据达米科标准,患者被分为低风险(14.3%)、中风险(67.4%)和高风险(18.4%)组。所有患者的平均随访时间为13.1±7.29个月。术后90天内无患者被诊断为BNC。随后有2例患者(4%)被诊断并接受了BNC治疗,其中1例在诊断前无症状。
在RRP过程中使用Capio™ RP装置,我们能够实现与RALP报道的发生率相当的BNC发生率。使用Capio™ RP装置似乎是一种提高RRP尿道膀胱吻合术结果的经济有效的方法。