Department of Urology, Tokyo Women's Medical University, Tokyo.
Department of Urology, Tokyo Women's Medical University, Tokyo.
Transplant Proc. 2022 Mar;54(2):525-527. doi: 10.1016/j.transproceed.2021.08.063. Epub 2022 Feb 11.
Prostate cancer (PCa) has increased as a long-term outcome of advanced immunosuppression in renal transplant recipients (RTRs). Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) is reportedly less time-consuming and has a higher continence recovery rate than the standard RARP without increasing the risk of complications. However, only a few cases of Rs-RARP in RTRs have been reported.
A 65-year-old man, who received a renal transplant 2 years prior, was diagnosed with low-risk PCa, per the D'Amico risk classification system, and underwent Rs-RARP with the da Vinci Xi robotic system. All port sites were placed contralateral to the allograft and compared with the standard RARP. The operative time was 187 min, and the estimated blood loss was 100 mL. The urethral catheter was removed on postoperative day 7 after confirming the absence of leakage using voiding cystourethrography. The patient was discharged on postoperative day 8. Pathologic findings showed localized PCa with a Gleason score of 3 + 3 and negative surgical margins. One year after the surgery, the patient had adequate urinary continence. His prostate-specific antigen level was <0.01 ng/mL, and his renal function was similar to that before surgery.
We reported a case of PCa in an RTR, successfully treated via Rs-RARP, resulting in adequate continence without complications.
前列腺癌 (PCa) 是肾移植受者 (RTR) 接受先进免疫抑制治疗的长期后果之一。保留耻骨后间隙的机器人辅助根治性前列腺切除术 (Rs-RARP) 据报道比标准 RARP 耗时更短，控尿恢复率更高，且不会增加并发症风险。然而，仅有少数 RTR 接受 Rs-RARP 的病例报告。
一名 65 岁男性，2 年前接受了肾移植，根据 D'Amico 风险分类系统诊断为低危 PCa，接受了保留耻骨后间隙的机器人辅助根治性前列腺切除术（Rs-RARP），使用达芬奇 Xi 机器人系统。所有端口均放置在移植物的对侧，并与标准 RARP 进行比较。手术时间为 187 分钟，估计失血量为 100 毫升。在使用排尿性膀胱尿道造影确认无漏尿后，于术后第 7 天拔出尿道导管。术后第 8 天患者出院。病理检查显示局限性 PCa，Gleason 评分为 3+3，切缘阴性。手术后 1 年，患者具有足够的尿控能力。他的前列腺特异性抗原水平<0.01ng/ml，肾功能与手术前相似。
我们报告了 1 例 RTR 中的 PCa 病例，成功通过 Rs-RARP 治疗，结果控尿良好且无并发症。
