Uffort Ekong E, Jensen James C
Department of Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
Edwards Comprehensive Cancer Center and Department of Surgery/Divison of Urology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA.
J Robot Surg. 2010 May;4(1):7-10. doi: 10.1007/s11701-010-0180-4. Epub 2010 Apr 1.
To substantiate robotic-assisted laparoscopic simple prostatectomy (RLSP) as an alternative minimal invasive approach for the treatment of prostatic adenoma. Retrospective chart review performed with institutional review board (IRB) approval. Demographic and clinical data were collected on 15 men between May 2007 and October 2009 who underwent RLSP for urinary retention secondary to benign prostate hypertrophy (BPH) and complicated by significant median lobe hypertrophy, bladder diverticula and/or stones. International Prostate Symptoms Score (IPSS), postvoid residual (PVR), prostate-specific antigen (PSA) and cystoscopy, urodynamics evaluation, and operative reports were reviewed and analyzed. Average age, PSA, IPSS, and PVR in the series were 65.8 years, 5.17 ng/ml, 23.85, and 265.79 ml, respectively. Eleven men (73%) had urinary retention at presentation, 93.3% had significant intravesical lobe hypertrophy, 13.3% had bladder diverticula with/without stones, and mean prostate volume was 70.85 ml. All the men complained principally of persistent lower urinary tract symptoms (LUTS) despite maximal medical treatment. Mean operative time, estimated blood loss, and adenoma weight were 128.8 min, 139.3 ml, and 46.4 g, respectively. Mean hospital stay was 2.5 days with average postoperative Foley catheter time of 4.6 days. The only significant complication in the series was a postoperative incarcerated hernia in a patient with intraoperative repair of inguinal hernia. Postoperatively, symptom score improved significantly to an average of 8.13 (P = 0.0002), and urine residual also improved to an average of 44.19 ml (P ≤ 0.0001). Significant improvement from the sequelae of BPH can be successfully achieved with RLSP.
证实机器人辅助腹腔镜单纯前列腺切除术（RLSP）可作为治疗前列腺腺瘤的一种替代性微创方法。在获得机构审查委员会（IRB）批准后进行回顾性病历审查。收集了2007年5月至2009年10月期间15例因良性前列腺增生（BPH）继发尿潴留且合并明显中叶增生、膀胱憩室和/或结石而接受RLSP手术的男性患者的人口统计学和临床数据。对国际前列腺症状评分（IPSS）、残余尿量（PVR）、前列腺特异性抗原（PSA）以及膀胱镜检查、尿动力学评估和手术报告进行了回顾和分析。该系列患者的平均年龄、PSA、IPSS和PVR分别为65.8岁、5.17 ng/ml、23.85和265.79 ml。11例男性（73%）就诊时存在尿潴留，93.3%有明显膀胱内叶增生，13.3%有膀胱憩室伴/不伴结石，平均前列腺体积为70.85 ml。所有男性患者尽管接受了最大程度的药物治疗，但主要仍抱怨有持续的下尿路症状（LUTS）。平均手术时间、估计失血量和腺瘤重量分别为128.8分钟、139.3 ml和46.4 g。平均住院时间为2.5天，术后留置导尿管平均时间为4.6天。该系列中唯一的严重并发症是1例术中修补腹股沟疝的患者术后发生嵌顿疝。术后，症状评分显著改善至平均8.13（P = 0.0002），残余尿量也改善至平均44.19 ml（P≤0.0001）。RLSP可成功实现BPH后遗症的显著改善。
