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单孔机器人辅助单纯前列腺切除术:技术与结果。

Single-port robot-assisted simple prostatectomy: techniques and outcomes.

机构信息

Department of Urology, Rush University Medical Center, 1725 W. Harrison Street, Suite 970, Chicago, IL, 60612, USA.

Department of Urology, University of Verona, Verona, Italy.

出版信息

World J Urol. 2024 Feb 23;42(1):98. doi: 10.1007/s00345-024-04778-9.

DOI:10.1007/s00345-024-04778-9
PMID:38393399
Abstract

PURPOSE

To describe the surgical techniques and to analyse the outcomes of single-port robot-assisted simple prostatectomy (SP RASP) procedure for the surgical treatment of benign prostatic hyperplasia (BPH).

METHODS

Three databases (PubMed®, Web of Science™, and Scopus®) were queried to identify studies reporting on the technical aspects and outcomes of SP RASP. Different combinations of keywords were used, according to a free-text protocol, to identify retrospective and prospective studies, both comparative and non-comparative, systematic reviews (SR) and meta-analysis (MA) describing surgical techniques for SP RASP and the associated surgical and functional outcomes.

RESULTS

The transvesical approach represents the most common approach for SP RASP. A decrease in terms of estimated blood loss was observed when SP RASP was compared to open simple prostatectomy (OSP) and multi-port (MP) RASP. Furthermore, this technique allowed for a shorter length of hospital stay (LoS) and a lower post-operative complication rate, compared to OSP. Post-operative subjective and objective functional outcomes are satisfying and comparable to OSP and MP RASP.

CONCLUSION

SP RASP represents a safe and feasible approach for the surgical management of BPH. It provides comparable surgical and functional outcomes to MP RASP, enabling for minimal invasiveness, enhanced recovery, and potential for improving patient care.

摘要

目的

描述单端口机器人辅助单纯前列腺切除术(SP RASP)治疗前列腺增生(BPH)的手术技术,并分析其疗效。

方法

在 PubMed®、Web of Science™和 Scopus®三个数据库中检索报道 SP RASP 技术方面和疗效的研究。根据自由文本方案,使用不同的关键词组合,以识别描述 SP RASP 手术技术及相关手术和功能结果的回顾性和前瞻性研究、比较和非比较研究、系统评价(SR)和荟萃分析(MA)。

结果

经膀胱途径是 SP RASP 最常用的途径。与开放单纯前列腺切除术(OSP)和多端口(MP)RASP 相比,SP RASP 可减少估计失血量。此外,与 OSP 相比,SP RASP 还可缩短住院时间(LoS)和降低术后并发症发生率。术后主观和客观功能结果令人满意,与 OSP 和 MP RASP 相当。

结论

SP RASP 是治疗 BPH 的一种安全可行的方法。它提供了与 MP RASP 相当的手术和功能结果,实现了微创、快速康复,并有可能改善患者的护理。

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Single-port robot-assisted simple prostatectomy: techniques and outcomes.单孔机器人辅助单纯前列腺切除术:技术与结果。
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本文引用的文献

1
Single Port Versus Multiport Robot-assisted Simple Prostatectomy: A Multi-institutional Study From the Single-port Advanced Research Consortium (SPARC).单孔与多孔机器人辅助单纯前列腺切除术:来自单孔高级研究联盟(SPARC)的多机构研究。
Urology. 2023 Jun;176:94-101. doi: 10.1016/j.urology.2023.03.022. Epub 2023 Mar 29.
2
Transvesical Percutaneous Access Allows for Epidural Anesthesia Without Mechanical Ventilation in Single-Port Robotic Radical and Simple Prostatectomy.经膀胱经皮入路可在单孔机器人根治性和单纯性前列腺切除术时无需机械通气行硬膜外麻醉。
Urology. 2023 May;175:209-215. doi: 10.1016/j.urology.2023.01.046. Epub 2023 Feb 22.
3
Robotic assisted simple prostatectomy versus other treatment modalities for large benign prostatic hyperplasia: a systematic review and meta-analysis of over 6500 cases.
机器人辅助单纯前列腺切除术与其他治疗方法治疗大体积良性前列腺增生的比较:超过 6500 例的系统评价和荟萃分析。
Prostate Cancer Prostatic Dis. 2023 Sep;26(3):495-510. doi: 10.1038/s41391-022-00616-4. Epub 2022 Nov 19.
4
Single-Port Robotic Surgery: General Principles and Troubleshooting.单孔机器人手术:一般原则及故障排除。
J Endourol. 2022 Sep;36(S2):S25-S28. doi: 10.1089/end.2022.0313.
5
Single-port transvesical versus open simple prostatectomy: a perioperative comparative study.经单孔经膀胱前列腺切除术与开放性单纯前列腺切除术的围手术期对比研究。
Prostate Cancer Prostatic Dis. 2023 Sep;26(3):538-542. doi: 10.1038/s41391-022-00566-x. Epub 2022 Jul 18.
6
The Multi-Institutional Experience in Single-Port Robotic Transvesical Simple Prostatectomy for Benign Prostatic Hyperplasia Management. Reply.单孔机器人经膀胱单纯前列腺切除术治疗良性前列腺增生的多机构经验。回复
J Urol. 2022 Sep;208(3):566. doi: 10.1097/JU.0000000000002785. Epub 2022 Jun 3.
7
A Transition Toward a Faster Recovery in Single-Port Transvesical Simple Prostatectomy.单孔经膀胱前列腺切除术更快恢复的转变。
J Endourol. 2022 Aug;36(8):1036-1042. doi: 10.1089/end.2021.0805. Epub 2022 May 20.
8
Robot-assisted Simple Prostatectomy Is Better than Endoscopic Enucleation of the Prostate.机器人辅助简单前列腺切除术优于内镜前列腺剜除术。
Eur Urol Focus. 2022 Mar;8(2):368-370. doi: 10.1016/j.euf.2022.03.014. Epub 2022 Mar 26.
9
Robot-Assisted Simple Prostatectomy Endoscopic Enucleation of the Prostate: A Systematic Review and Meta-Analysis of Comparative Trials.机器人辅助单纯前列腺切除术与前列腺内镜切除术的比较:系统评价和荟萃分析。
J Endourol. 2022 Aug;36(8):1018-1028. doi: 10.1089/end.2021.0788. Epub 2022 Feb 7.
10
Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE PART II-Surgical Evaluation and Treatment.良性前列腺增生所致下尿路症状的管理:AUA 指南第二部分-手术评估与治疗。
J Urol. 2021 Oct;206(4):818-826. doi: 10.1097/JU.0000000000002184. Epub 2021 Aug 13.