Division of Urology, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
King Hussein Cancer Center, Amman, Jordan.
J Endourol. 2021 Jul;35(7):1025-1029. doi: 10.1089/end.2020.0859. Epub 2021 Jan 6.
The functional and oncologic outcomes of robot-assisted radical prostatectomy (RARP) in octogenarians are not well studied. We sought to study the perioperative, functional, and oncologic outcomes of RARP in octogenarian men. Between January 2009 and 2019, 46 patients ≥80 years with localized prostate cancer (PCa) underwent RARP in three high-volume robotic urologic practices in the United States. Clinical and pathologic features, and perioperative and postoperative complications were retrospectively evaluated. Functional outcomes for urinary and sexual function were collected via patient-reported questionnaires. Continence was defined as the use of zero or one safety pad per day. The median (interquartile range) age was 81 (80-82), the mean (standard deviation [SD]) operative time was 116.5 (36.4) minutes, and the mean (SD) blood loss was 132 (35.6) mL. All cases were completed robotically, no intraoperative complications were encountered, and the mean length of stay was 1.21 (0.78) days. Regarding 30- and 90-day complication, nine patients had postoperative complications; seven were Clavien-Dindo grade I-II, and two were Clavien-Dindo grade ≥III. Post-RARP continence rates at 3 and 12 months were 68.4% and 84.8%, respectively. RARP represents a feasible option to treat PCa in well-selected octogenarian men. Careful patient selection and counseling are critical before offering surgical treatment for these men.
机器人辅助根治性前列腺切除术（RARP）在 80 岁以上患者中的功能和肿瘤学结果尚未得到充分研究。我们旨在研究 80 岁以上男性接受 RARP 的围手术期、功能和肿瘤学结果。
在 2009 年 1 月至 2019 年期间，美国的三个高容量机器人泌尿科实践中，有 46 名局部前列腺癌（PCa）患者≥80 岁接受了 RARP。回顾性评估了临床和病理特征以及围手术期和术后并发症。通过患者报告的问卷调查收集了尿功能和性功能的功能结果。控尿定义为每天使用零个或一个安全垫。
中位数（四分位距）年龄为 81（80-82）岁，平均（标准差[SD]）手术时间为 116.5（36.4）分钟，平均（SD）出血量为 132（35.6）mL。所有病例均通过机器人完成，术中未发生并发症，平均住院时间为 1.21（0.78）天。在 30 天和 90 天的并发症方面，9 名患者发生术后并发症；7 例为 Clavien-Dindo 分级 I-II 级，2 例为 Clavien-Dindo 分级≥III 级。RARP 后 3 个月和 12 个月的控尿率分别为 68.4%和 84.8%。
RARP 代表了为精心选择的 80 岁以上男性治疗 PCa 的可行选择。在为这些男性提供手术治疗之前，必须进行仔细的患者选择和咨询。
