机器人辅助腹腔镜前列腺切除术与腹腔镜根治性前列腺切除术尿控结果的比较。

Comparison of urinary continence outcome between robotic assisted laparoscopic prostatectomy versus laparoscopic radical prostatectomy.

作者信息

Asawabharuj Kittipak, Ramart Patkawat, Nualyong Chaiyong, Leewansangtong Sunai, Srinualnad Sittiporn, Taweemonkongsap Tawatchai, Chaiyaprasithi Bansithi, Amornvesukit Teerapon, Jitpraphai Siros, Soontrapa Suchai

出版信息

J Med Assoc Thai. 2014 Apr;97(4):393-8.

PMID:24964681

Abstract

OBJECTIVE

To compare urinary continent rate at six and 12-month postoperative period, and perioperative outcome between robotic-assisted laparoscopic radical prostatectomy (RALP) and laparoscopic radical prostatectomy (LRP) at Siriraj Hospital.

MATERIAL AND METHOD

All medical records of patients performed RALP and LRP between 2005 and 2010 were reviewed. Data composed of demographic information, perioperative outcome, and oncologic outcome. Moreover, the urinary continence rate was also collected at six and 12-month postoperative period by questionnaires based research design.

RESULTS

Between 2005 and 2010, we performed 548 cases of RALP and 613 cases of LRP. Only 486 cases of RALP (88.6%) and 561 cases of LRP (91.5%) had been followed-up more than 12 months. All demographic data including age, biopsy Gleason score, and preoperative PSA level in both groups were comparably. On the other hand, the perioperative outcome in RALP differed from LRP group significantly, including operative time (210 min vs. 255 min), blood loss (449 ml vs. 766 ml), blood transfusion rate (7.6% vs. 25.2%), and length of hospital stay (7 days vs. 8.6 days) (p < 0.001). The oncological outcome including pathologic tumor staging and Gleason score were comparably. Late complication such as anastamosis stricture was not different between the two groups (3.1% in RALP vs. 2.4% in LRP, p = 0.584). The continence rate of RALP and LRP groups at 6-month was 67.8% and 39% and at 12-month was 80% and 63.7%, respectively. The continence rate of RALP was better than LRP significantly.

CONCLUSION

From our experience, perioperative outcome and continence rate at six and 12-month of RALP group was significantly better than LRP group. The demographic data, oncological outcome, and anastamosis stricture rate were comparably in both groups. The most relevant preoperative predictors of urinary continence were patient's age and prostatic weight.

摘要

目的

比较诗里拉吉医院机器人辅助腹腔镜根治性前列腺切除术（RALP）与腹腔镜根治性前列腺切除术（LRP）术后6个月和12个月时的尿控率及围手术期结局。

材料与方法

回顾了2005年至2010年间接受RALP和LRP治疗的所有患者的病历。数据包括人口统计学信息、围手术期结局和肿瘤学结局。此外，术后6个月和12个月时还通过基于问卷调查的研究设计收集了尿控率。

结果

2005年至2010年间，我们实施了548例RALP和613例LRP。只有486例RALP（88.6%）和561例LRP（91.5%）接受了超过12个月的随访。两组的所有人口统计学数据，包括年龄、活检Gleason评分和术前PSA水平均具有可比性。另一方面，RALP组的围手术期结局与LRP组有显著差异，包括手术时间（210分钟对255分钟）、失血量（449毫升对766毫升）、输血率（7.6%对25.2%）和住院时间（7天对8.6天）（p<0.001）。包括病理肿瘤分期和Gleason评分在内的肿瘤学结局具有可比性。两组间诸如吻合口狭窄等晚期并发症无差异（RALP组为3.1%，LRP组为2.4%，p=0.584）。RALP组和LRP组术后6个月时的尿控率分别为67.8%和39%，术后12个月时分别为80%和63.7%。RALP组的尿控率显著优于LRP组。