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腹腔镜前列腺切除术:单中心病例系列。

LAPAROSCOPIC RADICAL PROSTATECTOMY: SINGLE CENTER CASE SERIES.

机构信息

Department of Urology, University Hospital Center Zagreb.

University of Zagreb School of Medicine, Zagreb, Croatia.

出版信息

Acta Clin Croat. 2022 Oct;61(Suppl 3):15-20. doi: 10.20471/acc.2022.61.s3.2.

Abstract

Laparoscopic radical prostatectomy (LRP) is traditionally characterized as a technically difficult procedure with a long learning curve but it is successfully performed worldwide. The aim of this paper was to assess the initial learning curve and clinical outcomes for LRP in our center. We performed a retrospective study including 63 LRP cases, in the course of 22 months, performed by 2 urologists, with no previous LRP experience. All patients were previously assessed by a multidisciplinary team and were selected on the basis of low and intermediate risk disease attributes according to the classification of prostate cancer risk groups of the European Association of Urology. The main outcomes of follow-up are procedure duration, estimated blood loss, complications, positive surgical margins, biochemical relapse and urinary continence. The median follow-up was 19.6 months. The median procedure duration was 196.8 minutes and median blood loss 257.1 mL. Significant decrease in both outcomes was observed when comparing first and last cases in the series. There were 5 (7.9%) Clavien Dindo grade II complications. Undetectable prostate specific antigen (PSA) was observed in 59 (93.6%) patients, and fifty-five patients (87.3%) were continent. Following a methodical learning approach, LRP can be safely mastered with favorable outcomes.

摘要

腹腔镜根治性前列腺切除术(LRP)传统上被认为是一种技术难度较大、学习曲线较长的手术,但它在全球范围内得到了成功开展。本文旨在评估我们中心 LRP 的初始学习曲线和临床结果。我们进行了一项回顾性研究,包括 63 例由 2 名泌尿科医生进行的 LRP 病例,他们均无 LRP 经验。所有患者均由多学科团队进行了评估,并根据欧洲泌尿外科学会前列腺癌风险组分类,根据低危和中危疾病特征选择了该手术。随访的主要结果是手术持续时间、估计失血量、并发症、切缘阳性、生化复发和尿控。中位随访时间为 19.6 个月。中位手术时间为 196.8 分钟,中位失血量为 257.1ml。在比较系列中的第一例和最后一例时,这两个结果都有显著下降。有 5 例(7.9%)Clavien Dindo II 级并发症。59 例(93.6%)患者前列腺特异性抗原(PSA)无法检测到,55 例(87.3%)患者有尿控。通过系统的学习方法,LRP 可以安全掌握,且结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01ca/10022405/3d1156adf59c/acc-61_supp3-15-f1.jpg

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