Department of Urology, Private Yuzyil Gebze Hospital, Kocaeli, Turkey.
Department of Urology, Bahcesehir University Medical Faculty, Istanbul, Turkey.
J Laparoendosc Adv Surg Tech A. 2024 Jan;34(1):19-24. doi: 10.1089/lap.2023.0337. Epub 2023 Sep 25.
To evaluate the oncological and functional outcomes of 167 patients who underwent laparoscopic radical prostatectomy (LRP). The retrospective study included 167 patients who were treated with LRP due to clinically localized prostate cancer between January 2007 and April 2012. Most of the patients were treated with the extraperitoneal approach. Preoperative evaluations included age, serum prostate-specific antigen (PSA) level, and biopsy Gleason score. Perioperative evaluations included duration of operative time and anastomosis time, blood loss (milliliter), and complications. Postoperative evaluations included length of hospital stay and catheterization time. Continence and erectile function were evaluated both pre- and postoperatively. The patients who used no pads or no more than one pad daily and the ones who had only a few urine leakages on effort or exertion were accepted as continent. Postoperative potency was defined as the ability to achieve sexual intercourse with or without the use of PDE-5 inhibitors. Mean age and mean operative time were 62.4 ± 6.0 years and 220.5 ± 45.6 minutes, respectively. Mean anastomosis time was 35.6 ± 9.8 minutes. Mean serum PSA level and mean Gleason score were 17.5 ± 9.97 ng/mL and 6.16 ± 0.42, respectively. Pelvic lymphadenectomy was performed in 94 patients and nerve-sparing procedures in 61 patients. The pathological analysis revealed positive surgical margin in 35 patients (20.9%). Bilateral and unilateral nerve-sparing LRP procedures were performed in 51 (30.5%) and 10 (6%) patients, respectively. At 12 months after surgery, 3 (1.8%) patients were using 2 or more pads per day, 19 (26.4%) patients were satisfied with erection, hardness, and duration of intercourse, and 9 (12.5%) patients had an erection with insufficient hardness and duration. LRP is an acceptable method in localized prostate cancer due to its perioperative and early postoperative results.
评估 167 例接受腹腔镜根治性前列腺切除术（LRP）的患者的肿瘤学和功能结果。这项回顾性研究纳入了 2007 年 1 月至 2012 年 4 月期间因临床局限性前列腺癌接受 LRP 治疗的 167 例患者。大多数患者采用了腹膜外入路。术前评估包括年龄、血清前列腺特异性抗原（PSA）水平和活检 Gleason 评分。围手术期评估包括手术时间和吻合时间、失血量（毫升）和并发症。术后评估包括住院时间和导尿管留置时间。术前和术后均评估控尿和勃起功能。使用无尿垫或每天使用不超过一个尿垫且仅在用力或用力时发生少量尿失禁的患者被认为是控尿的。术后勃起功能定义为能够在不使用 PDE-5 抑制剂或使用 PDE-5 抑制剂的情况下进行性交。平均年龄和平均手术时间分别为 62.4±6.0 岁和 220.5±45.6 分钟。平均吻合时间为 35.6±9.8 分钟。平均血清 PSA 水平和平均 Gleason 评分分别为 17.5±9.97ng/mL 和 6.16±0.42。94 例患者行盆腔淋巴结清扫术，61 例行神经保留手术。病理分析显示 35 例（20.9%）患者有阳性切缘。51 例（30.5%）和 10 例（6%）患者分别行双侧和单侧神经保留 LRP 手术。术后 12 个月，3 例（1.8%）患者每天使用 2 个或更多尿垫，19 例（26.4%）患者对勃起、硬度和性交持续时间满意，9 例（12.5%）患者勃起硬度和持续时间不足。LRP 是一种可接受的治疗局限性前列腺癌的方法，因为其围手术期和早期术后结果良好。
