Abdelhakim Mahmoud, Morsy Samer, Abdelghany Mohamed, Fouad Abdelhamid, Abdelwahab Mohamed
Department of Urology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.
Int Urol Nephrol. 2025 Jan 30. doi: 10.1007/s11255-025-04384-7.
To evaluate the outcomes and efficacy of robot-assisted radical prostatectomy (RARP) using the Versius robotic surgical system, aiming to provide comprehensive data on perioperative outcomes, postoperative recovery, and complications.
All cases of RARP using the CMR Versius platform performed at Cairo University Hospital over a two-year period were enrolled in this study. All patients had pathologically confirmed prostate cancer in both localized and locally advanced stages. Data were prospectively collected including preoperative parameters as patients' demographics, serum PSA, and Gleason score after trans-rectal ultrasound guided biopsy. Intraoperative parameters and complications were assessed. Postoperatively, we monitored the oncological and functional outcomes such as continence and sexual functions for at least 12 months. Follow up of PSA was done at 6 weeks, 3 and 6 months, postoperatively.
One-hundred-and-eighteen patients continued the follow-up till 12 months. The median patient age was 64.26 ± 7.13 years. The median PSA value at diagnosis was 9 (4.16-64) ng/ml and the median prostate size was 50 (20-167) grams. The mean docking time, console time, and the total operative time were 13.17 ± 1.157, 194.75 ± 24.3 and 225.76 ± 25 min, respectively and the median blood loss was 307.46 ± 61.44 ml. The mean hospital stay and the mean catheter time were 2.16 ± 0.867 and 7.26 ± 1.441 days, respectively. Forty-nine patients underwent nerve-sparing RARP (bilateral in 41 patients and unilateral in 8 patients). Post-operative continence and potency showed progressive improvement over time during follow-up. Twelve months postoperatively, 90.7% of patients were totally continent and 49% of those patients who underwent nerve-sparing RARP (24/49) were potent.
With a positive safety profile and a successful oncological outcome, the use of the CMR system for robot-assisted radical prostatectomy presents a safe and promising method in the surgical management of prostate cancer.
评估使用Versius机器人手术系统进行机器人辅助根治性前列腺切除术（RARP）的效果和疗效，旨在提供围手术期结果、术后恢复及并发症的全面数据。
本研究纳入了开罗大学医院在两年期间使用CMR Versius平台进行的所有RARP病例。所有患者均经病理证实患有局限性和局部晚期前列腺癌。前瞻性收集数据，包括术前参数，如患者人口统计学资料、血清前列腺特异抗原（PSA）以及经直肠超声引导下活检后的Gleason评分。评估术中参数及并发症。术后，我们监测了肿瘤学和功能结果，如控尿和性功能，至少持续12个月。术后6周、3个月和6个月进行PSA随访。
118例患者持续随访至12个月。患者中位年龄为64.26±7.13岁。诊断时PSA中位值为9（4.16 - 64）ng/ml，前列腺中位大小为50（20 - 167）克。平均对接时间、控制台操作时间和总手术时间分别为13.17±1.157、194.75±24.3和225.76±25分钟，中位失血量为307.46±61.44毫升。平均住院时间和平均导尿管留置时间分别为2.16±0.867天和7.26±1.441天。49例患者接受了保留神经的RARP（41例双侧保留，8例单侧保留）。随访期间，术后控尿和性功能随时间逐渐改善。术后12个月，90.7%的患者完全控尿，接受保留神经RARP的患者中49%（24/49）性功能恢复。
CMR系统用于机器人辅助根治性前列腺切除术具有良好的安全性和成功的肿瘤学结果，在前列腺癌的手术治疗中是一种安全且有前景的方法。
