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前瞻性近距离放射治疗与达芬奇机器人前列腺切除术系列短期功能结果和生活质量的比较分析

Comparative analysis of short - term functional outcomes and quality of life in a prospective series of brachytherapy and Da Vinci robotic prostatectomy.

作者信息

García-Sánchez Cristina, Martín Ana A Román, Conde-Sánchez J Manuel, Congregado-Ruíz C Belén, Osman-García Ignacio, Medina-López Rafael A

机构信息

Virgen del Rocío Universitary Hospital, Seville, Spain.

出版信息

Int Braz J Urol. 2017 Mar-Apr;43(2):216-223. doi: 10.1590/S1677-5538.IBJU.2016.0098.

Abstract

INTRODUCTION

There is a growing interest in achieving higher survival rates with the lowest morbidity in localized prostate cancer (PC) treatment. Consequently, minimally invasive techniques such as low-dose rate brachytherapy (BT) and robotic-assisted prostatectomy (RALP) have been developed and improved. Comparative analysis of functional outcomes and quality of life in a prospective series of 51BT and 42Da Vinci prostatectomies DV Materials and Methods: Comparative analysis of functional outcomes and quality of life in a prospective series of 93 patients with low-risk localized PC diagnosed in 2011. 51patients underwent low-dose rate BT and the other 42 patients RALP. IIEF to assess erectile function, ICIQ to evaluate continence and SF36 test to quality of life wee employed.

RESULTS

ICIQ at the first revision shows significant differences which favour the BT group, 79% present with continence or mild incontinence, whereas in the DV group 45% show these positive results. Differences disappear after 6 months, with 45 patients (89%) presenting with continence or mild incontinence in the BT group vs. 30 (71%) in the DV group. 65% of patients are potent in the first revision following BT and 39% following DV. Such differences are not significant and cannot be observed after 6 months. No significant differences were found in the comparative analysis of quality of life.

CONCLUSIONS

ICIQ after surgery shows significant differences in favour of BT, which disappear after 6 months. Both procedures have a serious impact on erectile function, being even greater in the DV group. Differences between groups disappear after 6 months.

摘要

引言

在局部前列腺癌(PC)治疗中,人们越来越关注以最低的发病率实现更高的生存率。因此,诸如低剂量率近距离放射治疗(BT)和机器人辅助前列腺切除术(RALP)等微创技术得到了发展和改进。对51例BT和42例达芬奇前列腺切除术患者进行前瞻性系列研究,比较其功能结局和生活质量。材料与方法:对2011年诊断为低风险局部PC的93例患者进行前瞻性系列研究,比较其功能结局和生活质量。51例患者接受低剂量率BT,另外42例患者接受RALP。采用国际勃起功能指数(IIEF)评估勃起功能,国际尿失禁咨询问卷(ICIQ)评估尿失禁情况,健康调查简表(SF36)测试生活质量。

结果

首次复查时ICIQ显示出显著差异,有利于BT组,79%的患者尿失禁或轻度尿失禁,而在DV组中,45%的患者有这些阳性结果。6个月后差异消失,BT组45例(89%)患者尿失禁或轻度尿失禁,而DV组为30例(71%)。BT术后首次复查时65%的患者有性功能,DV术后为39%。这些差异不显著,6个月后无法观察到。在生活质量的比较分析中未发现显著差异。

结论

术后ICIQ显示出有利于BT的显著差异,6个月后消失。两种手术对勃起功能均有严重影响,DV组影响更大。两组间的差异6个月后消失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0db3/5433359/e95a6b18df2c/1677-5538-ibju-43-02-0216-gf01.jpg

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