Timm Brennan, O'Connor Ellen, Bolton Damien, Liodakis Peter
Department of Urology, Austin Health, Heidelberg, VIC, Australia.
North Eastern Urology, Heidelberg, VIC, Australia.
J Robot Surg. 2020 Dec;14(6):861-864. doi: 10.1007/s11701-020-01063-w. Epub 2020 Mar 9.
The use of robot-assisted laparoscopic radical prostatectomy (RALP) continues to increase in the management of prostate cancer by minimally invasive approach, with shorter convalescence, reduced blood transfusion and improving oncological outcomes when compared to open surgery. There is a growing evidence base that RALP is significantly associated with incisional hernia (IH) at the specimen extraction site compared to open surgery. A series of 186 RALP patients between August 2012 and August 2018 was reviewed, where 1-7 years follow-up had been observed. The study endpoint was IH rate at the supraumbilical specimen extraction site utilized by the surgeon. Incisional hernia rate at specimen extraction site was 8.6% and incidental 1.1% IH rate at a lateral port site (not associated with specimen removal). Average age at operation was 60.9 years old and hernias were diagnosed at a mean of 11.8 months post-surgery. Common demographics in the population suffering from IH were previous abdominal surgery, adhesiolysis, history of smoking and obesity. Supraumbilical extraction site hernias are an underreported complication of RALP which may impact on quality of life and prompt further surgical correction. Patients should be asked for consent regarding the possibility of this complication ensuing.
机器人辅助腹腔镜根治性前列腺切除术（RALP）在前列腺癌的微创治疗中应用持续增加，与开放手术相比，其恢复期更短、输血减少且肿瘤学结局更佳。越来越多的证据表明，与开放手术相比，RALP与标本提取部位的切口疝（IH）显著相关。回顾了2012年8月至2018年8月期间的186例RALP患者，观察了1至7年的随访情况。研究终点是外科医生使用的脐上标本提取部位的IH发生率。标本提取部位的切口疝发生率为8.6%，侧端口部位（与标本取出无关）的偶然IH发生率为1.1%。手术平均年龄为60.9岁，疝在术后平均11.8个月被诊断出来。患有IH的人群的常见人口统计学特征包括既往腹部手术、粘连松解术、吸烟史和肥胖。脐上提取部位疝是RALP一种报告不足的并发症，可能影响生活质量并促使进一步的手术矫正。应就这种并发症发生的可能性征求患者的同意。
