Jo Seon Beom, Kim Jong Wook
Department of Pharmacology, Korea University College of Medicine, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea.
Cancers (Basel). 2025 Mar 6;17(5):902. doi: 10.3390/cancers17050902.
Prostate cancer is one of the most commonly diagnosed malignancies worldwide and is a major cause of cancer-associated morbidity in men. Radical prostatectomy (RP) is a cornerstone of intervention for organ-confined diseases and offers a potentially curative outcome. In recent decades, RP has undergone transformative changes, moving from open surgery, with significant morbidity, to minimally invasive and robot-assisted techniques. These advances have improved surgical precision, reduced blood loss, and accelerated functional recovery. Key enhancements, such as the "Veil of Aphrodite", hood-sparing, and Retzius-sparing approaches, aim to preserve neurovascular structures vital for continence and sexual function, addressing the persistent challenge of balancing oncological control with quality-of-life outcomes. Single-port (SP) robotic platforms represent the latest frontier, offering various access routes, including extraperitoneal, transvesical, transperitoneal, and transperineal routes, to further reduce incisional morbidity. Early experiences with SP robot-assisted radical prostatectomy(RARP) suggest favorable continence rates and short hospital stays, although concerns remain regarding the technical complexity and potential margin status of the advanced disease. Comparisons across these techniques revealed broadly similar long-term oncological outcomes, underscoring the importance of patient selection, tumor staging, and surgeon expertise. Ongoing innovations in robotic systems, augmented imaging modalities, and personalized surgical planning are likely to refine prostate cancer care and enhance both survival and post-treatment quality of life.
前列腺癌是全球最常被诊断出的恶性肿瘤之一，也是男性癌症相关发病的主要原因。根治性前列腺切除术（RP）是治疗器官局限性疾病的基石，有望实现治愈。近几十年来，RP经历了变革性变化，从具有较高发病率的开放手术发展到微创和机器人辅助技术。这些进展提高了手术精度，减少了失血，并加速了功能恢复。关键的改进措施，如“阿佛洛狄忒之幕”、保留耻骨后间隙和保留Retzius间隙的方法，旨在保留对控尿和性功能至关重要的神经血管结构，应对在肿瘤控制与生活质量结果之间取得平衡这一持续挑战。单孔（SP）机器人平台代表了最新前沿技术，提供了包括腹膜外、经膀胱、经腹腔和经会阴途径在内的多种入路，以进一步降低切口发病率。早期单孔机器人辅助根治性前列腺切除术（RARP）的经验表明控尿率良好且住院时间短，尽管对于晚期疾病的技术复杂性和潜在切缘状态仍存在担忧。对这些技术的比较显示长期肿瘤学结果大致相似，强调了患者选择、肿瘤分期和外科医生专业知识的重要性。机器人系统、增强成像模式和个性化手术规划方面的持续创新可能会优化前列腺癌治疗，并提高生存率和治疗后生活质量。
