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机器人辅助根治性前列腺切除术侧入路的结果:单中心经验的见解。

Outcomes of lateral approach in robot-assisted radical prostatectomy: insights from a single-surgeon experience.

机构信息

Department of Urology, Polytechnic University of Marche, Azienda Ospedaliera Universitaria della Marche, 71 Conca Street, 60126, Ancona, Italy.

Urology Unit, Clinique Saint Augustin, Bordeaux, France.

出版信息

J Robot Surg. 2024 Jan 13;18(1):24. doi: 10.1007/s11701-023-01772-y.

Abstract

In the era of robotic prostate surgery, various techniques have been developed to improve functional outcomes. Urinary continence has shown satisfactory results, but the preservation of lateral nerves to the periprostatic capsule is only achievable by sparing the pubovesical complex. This study aims to present the first cases of lateral-approach robot-assisted radical prostatectomy (LRRP) performed by a novice surgeon. We conducted a retrospective analysis of 70 prostate cancer patients who underwent LRRP between October 2019 and September 2021, analyzing the perioperative and functional outcomes. The median operative time and intraoperative blood loss were 102 (92-108) minutes and 150 (130-180) mL, respectively. Five minor postoperative complications were reported, and the median hospital stay was 2 (1-2) days. Eleven positive surgical margins occurred. Potency and urinary continence recovery were achieved in 59 (84%) and 66 (94%) patients, respectively, 12 months after surgery. Our analysis shows that LRRP is a safe and effective procedure for prostate cancer surgery. Continence and potency recovery required a short learning curve, with an acceptable recovery rate even in the initial cases.

摘要

在机器人前列腺手术时代,已经开发出各种技术来提高功能结果。尿控已显示出令人满意的结果,但只有通过保留耻骨膀胱复合体才能实现对前列腺包膜周围侧神经的保护。本研究旨在介绍由新手外科医生进行的首例外侧入路机器人辅助根治性前列腺切除术(LRRP)的病例。我们对 2019 年 10 月至 2021 年 9 月期间接受 LRRP 的 70 例前列腺癌患者进行了回顾性分析,分析了围手术期和功能结果。中位手术时间和术中出血量分别为 102(92-108)分钟和 150(130-180)毫升。报告了 5 例轻微术后并发症,中位住院时间为 2(1-2)天。11 例手术切缘阳性。术后 12 个月,59 例(84%)患者恢复勃起功能,66 例(94%)患者恢复尿控。我们的分析表明,LRRP 是一种安全有效的前列腺癌手术方法。尿控和勃起功能恢复需要一个较短的学习曲线,即使在最初的病例中,恢复率也可以接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10d2/10787696/20954d6223be/11701_2023_1772_Fig1_HTML.jpg

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