Zhou Xiaochen, Deng Wen, Li Zhongyi, Zhang Cheng, Liu Weipeng, Guo Ju, Chen Luyao, Huang Wei, Lei Enjun, Zhang Xu, Jing Xiao, Fu Bin, Wang Gongxian
Department of Urology, the First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Urology, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Transl Androl Urol. 2023 Jun 30;12(6):989-1001. doi: 10.21037/tau-23-98.
This study presents the procedure of single-port extraperitoneal transvesical approach to robot-assisted radical prostatectomy (SETvRARP) on the da Vinci Xi platform coupling with a 4-channel single port and evaluated the short-term outcomes in the first 72 prostate cancer (PCa) patients.
Seventy-two patients with localized PCa were enrolled. Each operation was conducted by the same single robotic surgery group in two centers using the da Vinci Xi system.
The median operation time was 150 min, and the median estimated blood loss was 50 mL. All operations were successfully carried out without open conversion or transfusion. No ≥ Grade II complications were noted. Urethral catheters were routinely removed on postoperative day 7. Sixty-eight (94.4%) patients recovered to immediate urinary continence after surgery, with 72 (100%) patients achieving full continence on postoperative day 14. A positive surgical margin was observed in 15 (20.8%) patients. Postoperative urodynamic studies regarding peak urinary flow, bladder capacity, and residual urine were not statically different from the preoperative results. No biochemical recurrence was noted in all patients within the follow-up period. Postoperative erectile function was not statistically different from the preoperative results (P=0.1697).
SETvRARP using the da Vinci Xi system coupling with a 4-channel single port is a valid radical prostatectomy technique in well-selected PCa patients, resulting in superior postoperative recovery of urinary continence. Meanwhile, the outcomes in functional protection and cancer control need to be further investigated with a long-term follow-up duration.
本研究介绍了在达芬奇Xi平台上结合四通道单孔进行机器人辅助根治性前列腺切除术（SETvRARP）的手术步骤，并评估了前72例前列腺癌（PCa）患者的短期疗效。
纳入72例局限性PCa患者。每个手术均由同一机器人手术团队在两个中心使用达芬奇Xi系统进行。
中位手术时间为150分钟，中位估计失血量为50毫升。所有手术均成功完成，无需开放转换或输血。未发现≥Ⅱ级并发症。术后第7天常规拔除尿道导管。68例（94.4%）患者术后立即恢复控尿，72例（100%）患者在术后第14天实现完全控尿。15例（20.8%）患者观察到手术切缘阳性。术后尿动力学研究中的最大尿流率、膀胱容量和残余尿量与术前结果相比无统计学差异。随访期间所有患者均未发现生化复发。术后勃起功能与术前结果相比无统计学差异（P=0.1697）。
在精心挑选的PCa患者中，使用达芬奇Xi系统结合四通道单孔的SETvRARP是一种有效的根治性前列腺切除术技术，可使术后尿控恢复更佳。同时，功能保护和癌症控制方面的结果需要通过长期随访进一步研究。
