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手术加速康复方案对机器人辅助根治性前列腺切除术围手术期生活质量的影响:一项单中心前瞻性队列研究

Impact of Enhanced Recovery After Surgery Protocol on Perioperative Quality of Life in Robot-Assisted Radical Prostatectomy: A Single-Center Prospective Cohort Study.

作者信息

Nakamura Masaki, Muraki Yasuko, Yamada Yumi, Matsumoto Satoko, Tsuji Yuko, Tsuru Ibuki, Ono Akihiro, Watanabe Junko, Okabe Keiko, Kashiwagi Masanori, Kiuchi Akie, Izumi Taro, Amakawa Ryo, Inoue Yasushi, Yoshimatsu Tadashi, Fukuda Akira, Hayashi Michio, Komatsu Takami, Morikawa Teppei, Kameyama Shuji, Kume Haruki, Shiga Yoshiyuki

机构信息

Department of Urology, NTT Medical Center Tokyo, Tokyo, Japan.

Information System Group, NTT Medical Center Tokyo, Tokyo, Japan.

出版信息

Int J Urol. 2025 Jul 11. doi: 10.1111/iju.70177.

Abstract

OBJECTIVES

Enhanced recovery after surgery is a comprehensive, multidisciplinary perioperative care program designed to minimize postoperative complications. Despite its widespread use in urological surgeries, the effect of enhanced recovery after surgery on the quality of life during robot-assisted radical prostatectomy remains unclear. We performed a prospective cohort study to elucidate the effect of enhanced recovery following robot-assisted radical prostatectomy on patients' quality of life.

METHODS

This prospective cohort study included 150 consecutive patients who underwent robot-assisted radical prostatectomy at a single institution. A total of 133 patients were analyzed after excluding those with incomplete data. The patients were divided into two groups: 32 in the non-enhanced recovery group and 101 in the enhanced recovery group. To assess the quality of life, patients undergoing robot-assisted radical prostatectomy completed the Functional Assessment of Cancer Therapy-Prostate questionnaire 1 day before and 1 month after surgery.

RESULTS

Patient characteristics did not differ between the two groups. No significant differences were observed in the preoperative Functional Assessment of Cancer Therapy-Prostate scores between the groups. Perioperative changes in the physical well-being subscale for the non-enhanced recovery after surgery and enhanced recovery after surgery groups were -3.5 and -2.0, respectively (p = 0.0463). Furthermore, enhanced recovery after surgery was a significant predictor of a smaller perioperative decline in the Functional Assessment of Cancer Therapy-Prostate Physical Well-Being subscale score.

CONCLUSION

Enhanced recovery after surgery helps to preserve physical well-being during robot-assisted radical prostatectomy.

摘要

目的

术后加速康复是一项旨在将术后并发症降至最低的综合性、多学科围手术期护理计划。尽管其在泌尿外科手术中广泛应用,但术后加速康复对机器人辅助根治性前列腺切除术期间生活质量的影响仍不明确。我们进行了一项前瞻性队列研究,以阐明机器人辅助根治性前列腺切除术后加速康复对患者生活质量的影响。

方法

这项前瞻性队列研究纳入了在单一机构接受机器人辅助根治性前列腺切除术的150例连续患者。排除数据不完整的患者后,共分析了133例患者。患者分为两组:非加速康复组32例,加速康复组101例。为评估生活质量,接受机器人辅助根治性前列腺切除术的患者在手术前1天和手术后1个月完成癌症治疗功能评估-前列腺问卷。

结果

两组患者的特征无差异。两组术前癌症治疗功能评估-前列腺评分无显著差异。术后非加速康复组和加速康复组身体幸福感子量表的围手术期变化分别为-3.5和-2.0(p = 0.0463)。此外,术后加速康复是癌症治疗功能评估-前列腺身体幸福感子量表评分围手术期下降较小的重要预测因素。

结论

术后加速康复有助于在机器人辅助根治性前列腺切除术期间保持身体幸福感。

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