Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Prostate Cancer Prostatic Dis. 2023 Sep;26(3):538-542. doi: 10.1038/s41391-022-00566-x. Epub 2022 Jul 18.
To compare the initial perioperative outcomes of single-port transvesical simple prostatectomy (SP RASP) patients to those of open simple prostatectomy (OSP).
Perioperative data from 42 consecutive patients with BPH who underwent SP RASP were prospectively reviewed. Similarly, data from forty-three consecutive patients who underwent the standard OSP, were retrospectively collected. Through direct suprapubic bladder access, prostatic enucleation was performed using the prostatic capsule as a landmark. Then a complete vesicourethral mucosal advancement flap was accomplished. OSP was performed according to the standard approach. Demographics, Intra- and perioperative data were analyzed and assessed with a descriptive analysis.
Baseline characteristics were comparable between the two groups, except for the preoperative median post-void residual volume, which was higher in the OSP group (p = 0.004). The SP RASP group had less intraoperative estimated blood loss (p < 0.001), no need for continuous bladder irrigation (p < 0.001), and less in-hospital opioid use (p < 0.001). Patients in the SP RASP group were discharged on postoperative day zero, compared to a median of 2 days for OSP (p < 0.001). The median Foley catheter duration was 7 days for SP RASP, compared to a median of 10 days for OSP (p < 0.001). SP RASP group had fewer postoperative complications, however, this did not reach statistical significance.
SP RASP is an alternative approach in treating surgical BPH. It may offer patients less morbidity in comparison to OSP.
比较单孔经膀胱单纯前列腺切除术(SP RASP)患者与开放性单纯前列腺切除术(OSP)患者的围手术期初始结果。
前瞻性回顾了 42 例连续接受 SP RASP 的 BPH 患者的围手术期数据。同样,回顾性收集了 43 例连续接受标准 OSP 的患者的数据。通过直接耻骨上膀胱进入,使用前列腺包膜作为标志进行前列腺剜除。然后完成完整的膀胱尿道黏膜推进瓣。根据标准方法进行 OSP。分析并评估人口统计学、术中及围手术期数据,并进行描述性分析。
两组患者的基线特征相似,但术前平均剩余尿量除外,OSP 组更高(p = 0.004)。SP RASP 组术中估计出血量较少(p < 0.001),无需持续膀胱冲洗(p < 0.001),术后住院期间阿片类药物使用较少(p < 0.001)。SP RASP 组患者在术后第 0 天出院,而 OSP 组的中位数为 2 天(p < 0.001)。SP RASP 的 Foley 导管留置时间中位数为 7 天,而 OSP 的中位数为 10 天(p < 0.001)。SP RASP 组术后并发症较少,但这并未达到统计学意义。
SP RASP 是治疗外科 BPH 的一种替代方法。与 OSP 相比,它可能为患者带来更少的发病率。