Kapoor Ketan Kumar, Kumar Anup
Department of Urology and Renal Transplant, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Adv Urol. 2023 May 23;2023:4666116. doi: 10.1155/2023/4666116. eCollection 2023.
A prospective randomized comparative study was performed from 1st January 2020 to 30th June 2021. All patients included were diagnosed with localized/locally advanced ca prostate. 60 patients fulfilling the inclusion and exclusion criteria were randomized into 2 groups. Groups A and B included patients who underwent robot-assisted radical prostatectomy and 3D laparoscopic transperitoneal radical prostatectomy, respectively. Various demographic, intraoperative, postoperative, and follow-up parameters were collected. Outcomes were evaluated in the form of the trifecta (continence, potency, and BCR-free status) and pentafecta rates (trifecta with no perioperative complications and negative surgical margins) in between the two groups.
The mean operative time in Group A was 137.83 mins ± 17.27 compared to 148.20 mins ± 26.16 in Group B. Trifecta rates in Group A and Group B were 43.3%, 63.3%, and 76.6% and 40%, 53.3%, and 70% at 1, 3, and 6 months. Pentafecta rates in Group A and Group B were 36.6%, 53.3%, and 70% and 33.3%, 40%, and 53.3% at 1, 3, and 6 months. Complication rates were 10% in Group A and 13.3% in Group B, respectively. Only one patient in our study (Group B) had a positive surgical margin.
We conclude from our comparative study, that both robot-assisted and 3D laparoscopic transperitoneal radical prostatectomy are feasible and efficacious treatment modalities for achieving acceptable trifecta and pentafecta rates in managing ca prostate with earlier continence and shorter urethrovesical anastomosis time in the robotic arm.
2020年1月1日至2021年6月30日进行了一项前瞻性随机对照研究。纳入的所有患者均被诊断为局限性/局部晚期前列腺癌。60例符合纳入和排除标准的患者被随机分为两组。A组和B组分别包括接受机器人辅助根治性前列腺切除术和3D腹腔镜经腹根治性前列腺切除术的患者。收集了各种人口统计学、术中、术后及随访参数。以两组间的三联指标（控尿、性功能和无生化复发状态）和五联指标率（无围手术期并发症且手术切缘阴性的三联指标）形式评估结果。
A组平均手术时间为137.83分钟±17.27，而B组为148.20分钟±26.16。A组和B组在1、3和6个月时的三联指标率分别为43.3%、63.3%和76.6%以及40%、53.3%和70%。A组和B组在1、3和6个月时的五联指标率分别为36.6%、53.3%和70%以及33.3%、40%和53.3%。并发症发生率A组为10%，B组为13.3%。本研究中只有一名患者（B组）手术切缘阳性。
我们从比较研究中得出结论，机器人辅助和3D腹腔镜经腹根治性前列腺切除术都是可行且有效的治疗方式，在治疗前列腺癌时能达到可接受的三联指标和五联指标率，且机器人手术组控尿恢复更早，尿道膀胱吻合时间更短。
