Preliminary analysis of single center results about single port suprapubic transvesical robotic assisted radical prostatectomy
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摘要: 目的 探讨耻骨上经膀胱单孔机器人辅助前列腺癌根治术(SPSV-RARP)的临床效果并初步评估21例早期前列腺癌患者术后尿控情况。方法 回顾性分析2019年2—12月复旦大学附属中山医院采取SPSV-RARP治疗21例早期前列腺癌患者(cT1N0M0~cT2cN0M0)的临床资料。患者中位年龄为70岁，前列腺体积中位数为29.55 mL，术前前列腺特异性抗原(PSA)中位数为9.82 ng/mL。SPSV-RARP手术方式采用单切口进行，建立手术路径后，在机器人辅助腹腔镜下经膀胱完成前列腺根治性切除术，通过膀胱切口取出标本。记录患者围手术期情况并随访患者术后PSA及尿控情况。结果 21例患者行SPSV-RARP均顺利完成。中位手术时间为70 min，术中出血量中位数为95 mL，术后Gleason评分中位数为7分。患者切缘阳性率0，术后1个月PSA值均 < 0.02 ng/mL。21例患者术后拔除导尿管的中位时间为7 d。21例患者中，术后1、4、12和24周的平均每日使用尿垫量分别为1、1、0和0块。结论 SPSV-RARP在技术上是可行的，早期前列腺癌患者SPSV-RARP术后短期内可获得良好的瘤控和尿控效果。Abstract: Objective To investigate the clinical effect of single port suprapubic transvesical robotic assisted radical prostatectomy (SPSV-RARP) and to evaluate urinary continence outcomes in 21 patients with early prostate cancer.Methods From February to December 2019, 21 patients with early prostate cancer (cT1N0M0-cT2cN0M0) were enrolled and treated with SPSV-RARP. The median age was 70 years, the median prostate volume was 29.55 mL, and the median prostate specific antigen (PSA) was 9.82 ng/mL. SPSV-RARP was performed through a single incision. After the surgical path was established, the radical prostatectomy was performed via bladder under robot-assisted laparoscopy. Specimens were extracted through bladder incision. The patient's perioperative situation and daily use of pad during follow-up were recorded.Results All 21 SPSV-RARP cases were successfully completed. The median operative time was 70 min, the median intraoperative blood loss was 95 mL, and the median postoperative Gleason's score was 7. The positive rate of pathological sample margin was 0, and PSA value was＜0.02 ng/mL after 1 month of surgery. The catheter was removed 7 days after operation in all 21 patients. Among the 21 patients, the mean daily pads used at 1, 4, 12 and 24 weeks postoperatively were 1, 1, 0 and 0, respectively.Conclusion SPSV-RARP is feasible and can achieve good effects on tumor control and urinary continence in patients with early stage prostate cancer.
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Key words:
- prostate cancer /
- single-port robotic surgery /
- transvesical /
- tumor control /
- urinary continence
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