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机器人辅助根治性前列腺切除术的超保存术有助于早期恢复尿控。

Ultrapreservation in Robotic Assisted Radical Prostatectomy Provides Early Continence Recovery.

机构信息

Department of Urology, School of Medicine, University of Health Sciences, Umraniye Teaching Hospital, Istanbul, Turkey.

Department of Urology, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.

出版信息

JSLS. 2023 Jan-Mar;27(1). doi: 10.4293/JSLS.2022.00077.

Abstract

BACKGROUND AND OBJECTIVES

We aimed to evaluate oncological and functional results of the ultrapreservation anterior-sparing technique in patients with localized prostate cancer.

METHODS

In this single-center study, patients with low to intermediate risk prostate cancer, who were treated with the ultrapreservation anterior-sparing technique, were included retrospectively. The oncological and functional outcomes were recorded. After the functional and pathological evaluation in the first month, patients' prostate-specific antigen levels were followed, as well as continence and potency status bimonthly for one year. Continence is defined as no leakage and zero pads for security. Patients' potency was evaluated using the Sexual Health Inventory for Men, with ≥ 17 considered potent.

RESULTS

A total of 118 patients were included in the study. The pathological stage was pT2 in 78% (n = 92) of patients, with pT3 in 22% (n = 26). Surgical margin positivity occurred in 13.5% (n = 16) of patients. No complications were observed intraoperatively. Continence rates were 25.4% after catheter removal, rising to 88.9% in the first month, 91.5% in the third, 93.2% in the fifth, and 95.7% a year later. Thirty-five (40%) of 86 potent patients were potent in the first postoperative month, 48 patients (55.8%) were potent in the third month, and 58 patients (67.4%) were potent in the twelfth. The total complication rate was 8.4%, with no major complications observed.

CONCLUSION

The ultrapreservation anterior-sparing technique for patients with prostate cancer shows safe, acceptable functional and oncological results in short-term follow-up. However, long-term comparative studies with a larger number of patients are needed.

摘要

背景与目的

我们旨在评估局限性前列腺癌患者采用超保留前保技术的肿瘤学和功能学结果。

方法

在这项单中心研究中,回顾性纳入采用超保留前保技术治疗的低危至中危前列腺癌患者。记录肿瘤学和功能学结果。在第一个月进行功能和病理评估后,随访患者的前列腺特异性抗原水平,以及术后 1 年内每两个月的控尿和勃起功能状态。控尿定义为无漏尿和零尿垫。采用男性性功能健康量表评估患者的勃起功能,≥17 分视为勃起功能正常。

结果

共有 118 例患者纳入研究。病理分期为 pT2 的患者占 78%(n=92),pT3 的患者占 22%(n=26)。13.5%(n=16)的患者手术切缘阳性。术中未观察到任何并发症。拔除导尿管后控尿率为 25.4%,术后第一个月上升至 88.9%,第三个月上升至 91.5%,第五个月上升至 93.2%,一年后上升至 95.7%。86 例有勃起功能的患者中,35 例(40%)在术后第一个月勃起功能正常,48 例(55.8%)在第三个月勃起功能正常,58 例(67.4%)在第十二个月勃起功能正常。总并发症发生率为 8.4%,无严重并发症。

结论

在短期随访中,前列腺癌患者采用超保留前保技术具有安全、可接受的功能学和肿瘤学结果。然而,需要进行长期、与更大数量患者进行比较的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef60/10065757/15445e10eaa1/LS-JSLS230005F001.jpg

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