Jia Zepeng, Chang Yifan, Wang Yan, Li Jing, Qu Min, Zhu Feng, Chen Huan, Lian Bijun, Hua Meimian, Sun Yinghao, Gao Xu
Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Asian J Urol. 2021 Jan;8(1):126-133. doi: 10.1016/j.ajur.2020.01.003. Epub 2020 Jan 27.
To evaluate the safety profile and short-term functional outcome of sustainable functional urethral reconstruction (SFUR) in robotic-assisted radical prostatectomy (RARP).
One hundred and sixty-two consecutive prostate cancer patients who underwent RARP were retrospectively analyzed, in which 53 had undergone SFUR while the other 109 had undergone conventional RARP procedures. Immediate, 2-week, 1-month and 3-month continence recovery and other perioperative data were compared to evaluate short-term surgical and functional outcome.
The median age was 68 and 67 years in the experimental group and control group, respectively (=0.206), with a median prostate-specific antigen (PSA) of 13.6 ng/mL (interquartile range [IQR], 8.46-27.32 ng/mL) in the experimental group and 13.84 ng/mL (IQR, 9.12-26.80 ng/mL) in control group (=0.846). Immediate, 2-week, 1-month and 3-month continence recovery rates between the groups were 34.0% 3.7%, 50.9% 14.7%, 62.3% 27.5%, and 79.2% 63.3% (all <0.05). The morphological changes made by the new reconstruction technique were maintained on magnetic resonance imaging (MRI) 3 months postoperatively. Nerve-sparing procedures and adoption of the new reconstruction technique were significantly relevant to continence recovery on logistics regression model (<0.001).
SFUR is a safe and easy-to-handle modification that may contribute to early continence return for RARP. Long-term follow-up and prospective studies are required to further evaluate its value in postoperative quality-of-life improvement.
评估机器人辅助根治性前列腺切除术（RARP）中可持续功能性尿道重建（SFUR）的安全性和短期功能结果。
回顾性分析162例连续接受RARP的前列腺癌患者，其中53例行SFUR，另外109例行传统RARP手术。比较即时、2周、1个月和3个月时的控尿恢复情况及其他围手术期数据，以评估短期手术和功能结果。
试验组和对照组的中位年龄分别为68岁和67岁（=0.206），试验组前列腺特异性抗原（PSA）中位数为13.6 ng/mL（四分位间距[IQR]，8.46 - 27.32 ng/mL），对照组为13.84 ng/mL（IQR，9.12 - 26.80 ng/mL）（=0.846）。两组间即时、2周、1个月和3个月时的控尿恢复率分别为34.0% ± 3.7%、50.9% ± 14.7%、62.3% ± 27.5%和79.2% ± 63.3%（均<0.05）。新重建技术造成的形态学改变在术后3个月的磁共振成像（MRI）上得以维持。在逻辑回归模型中，保留神经手术和采用新重建技术与控尿恢复显著相关（<0.001）。
SFUR是一种安全且易于操作的改良方法，可能有助于RARP术后早期恢复控尿。需要长期随访和前瞻性研究来进一步评估其在改善术后生活质量方面的价值。
