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机器人辅助单纯前列腺切除术的中期尿功能和并发症结局。

Intermediate-term Urinary Function and Complication Outcomes After Robot-Assisted Simple Prostatectomy.

机构信息

Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.

Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.

出版信息

Urology. 2020 Jul;141:89-94. doi: 10.1016/j.urology.2020.04.055. Epub 2020 Apr 22.

Abstract

OBJECTIVE

To assess the incidence of delayed complications after robot-assisted simple prostatectomy and evaluate postoperative lower urinary tract symptoms (LUTS) as a function of time with intermediate-term follow-up.

METHODS

We retrospectively reviewed 150 patients who underwent robot-assisted simple prostatectomy between May, 2013 and January, 2019. Indication for surgery was bothersome LUTS refractory to medical management and prostate volume ≥80 milliliters. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS) and quality of life (QOL) score. One-way analysis of variance test with post hoc Tukey's honest significant difference test was used to compare postoperative IPSS and QOL scores as a function of time; P <.05 was considered significant.

RESULTS

At a mean ± SD follow up of 31.3 ± 18.2 months, none of the patients developed a bladder neck contracture and none of the patients required reoperation for LUTS. Postoperatively, IPSS and QOL scores decreased with an increasing duration of follow up (P <.001). Mean IPSS and QOL scores improved between 2 weeks and 3 months postoperatively (P = .027 and P = .006, respectively). After 3 months postoperatively, mean IPPS and QOL scores stabilized and remained unchanged up to 36 months of follow-up (all P >.05).

CONCLUSION

Robotic simple prostatectomy is associated with a low incidence of delayed complications at a mean of 31.3 months postoperatively. After robotic simple prostatectomy, urinary function outcomes improve in the early postoperative period with maximal improvement occurring at 3 months. Excellent urinary function outcomes are durable up to at least 36 months postoperatively.

摘要

目的

评估机器人辅助单纯前列腺切除术(RASP)后迟发性并发症的发生率,并在中期随访的基础上评估术后下尿路症状(LUTS)随时间的变化情况。

方法

我们回顾性分析了 2013 年 5 月至 2019 年 1 月期间接受 RASP 的 150 例患者。手术指征为药物治疗无效的令人困扰的 LUTS 和前列腺体积≥80 毫升。LUTS 的严重程度采用国际前列腺症状评分(IPSS)和生活质量(QOL)评分进行评估。采用单因素方差分析,组间比较采用 Tukey 事后检验,P<0.05 为差异有统计学意义。

结果

平均随访时间为 31.3±18.2 个月,所有患者均未发生膀胱颈挛缩,也无患者因 LUTS 再次手术。术后,随着随访时间的延长,IPSS 和 QOL 评分逐渐降低(P<0.001)。术后 2 周至 3 个月时,IPSS 和 QOL 评分改善(P=0.027 和 P=0.006)。术后 3 个月后,IPSS 和 QOL 评分稳定,直至 36 个月随访时无变化(均 P>0.05)。

结论

在平均 31.3 个月的随访中,RASP 术后迟发性并发症发生率较低。在 RASP 后,术后早期尿功能会有所改善,3 个月时改善最大。术后至少 36 个月时,尿功能效果持久。

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