PDF(Pubmed)
Abstract：
OBJECTIVE: To describe a technique to improve exposure of prostate during extraperitoneal robot-assisted radical prostatectomy (EP-RARP).
METHODS: From March 2020 to June 2022, a total of 41 patients with prior intra-abdominal surgery underwent EP-RARP. Twenty-three patients improved exposure by traction of prostate through urinary catheter. The catheter traction prostatectomy (CTP) group was compared with the standard prostatectomy (SP) group using three robotic arms (18 patients) in terms of estimated blood loss (EBL), operative time, positive surgical margin rate, the recovery rate of urinary continence, Gleason score and postoperative hospital stays. Differences were considered significant when P < 0.05.
RESULTS: The operative time was lower in the CTP group (109.63 min vs. 143.20 min; P < 0.001). EBL in the CTP group was 178.26 ± 30.70 mL, and in the standard prostatectomy group, it was 347.78 ± 53.53 mL (P < 0.001). No significant differences with regard to postoperative hospital stay, recovery rate of urinary continence, catheterization time and positive surgical margin were observed between both groups. No intraoperative complications occurred in all the patients. After 6 months of follow-up, the Post-op Detectable prostate specific antigen was similar between the two groups.
CONCLUSIONS: CTP is a feasible, safe, and valid procedure in EP-RARP. Application of CTP improved the exposure of prostate, reduced operative time and blood loss in comparison with the conventional procedure.
METHODS: From March 2020 to June 2022, a total of 41 patients with prior intra-abdominal surgery underwent EP-RARP. Twenty-three patients improved exposure by traction of prostate through urinary catheter. The catheter traction prostatectomy (CTP) group was compared with the standard prostatectomy (SP) group using three robotic arms (18 patients) in terms of estimated blood loss (EBL), operative time, positive surgical margin rate, the recovery rate of urinary continence, Gleason score and postoperative hospital stays. Differences were considered significant when P < 0.05.
RESULTS: The operative time was lower in the CTP group (109.63 min vs. 143.20 min; P < 0.001). EBL in the CTP group was 178.26 ± 30.70 mL, and in the standard prostatectomy group, it was 347.78 ± 53.53 mL (P < 0.001). No significant differences with regard to postoperative hospital stay, recovery rate of urinary continence, catheterization time and positive surgical margin were observed between both groups. No intraoperative complications occurred in all the patients. After 6 months of follow-up, the Post-op Detectable prostate specific antigen was similar between the two groups.
CONCLUSIONS: CTP is a feasible, safe, and valid procedure in EP-RARP. Application of CTP improved the exposure of prostate, reduced operative time and blood loss in comparison with the conventional procedure.
摘要：
目的：描述一种在腹膜外机器人辅助前列腺癌根治术（EP-RARP）中改善前列腺暴露的技术。
方法：从2020年3月至2022年6月，共有41例先前进行了腹腔内手术的患者接受了EP-RARP。23例患者通过导尿管牵引前列腺改善暴露。导管牵引前列腺切除术（CTP）组与标准前列腺切除术（SP）组使用三个机械臂（18例）在估计失血量（EBL）方面进行比较，手术时间,手术切缘阳性率，尿失禁的恢复率，Gleason评分和术后住院时间。当P<0.05时,认为差异显著。
结果：CTP组的手术时间更短（109.63minvs.143.20分钟；P<0.001）。CTP组EBL为178.26±30.70mL,在标准前列腺切除术组中，为347.78±53.53mL(P<0.001)。术后住院时间无显著差异，尿失禁的恢复率，观察两组导管插入时间和阳性手术切缘。所有患者均未发生术中并发症。经过6个月的随访，两组的术后可检测前列腺特异性抗原相似.
结论：CTP是可行的，安全,和EP-RARP中的有效程序。CTP的应用改善了前列腺的暴露，与常规手术相比，减少了手术时间和失血量。
方法：从2020年3月至2022年6月，共有41例先前进行了腹腔内手术的患者接受了EP-RARP。23例患者通过导尿管牵引前列腺改善暴露。导管牵引前列腺切除术（CTP）组与标准前列腺切除术（SP）组使用三个机械臂（18例）在估计失血量（EBL）方面进行比较，手术时间,手术切缘阳性率，尿失禁的恢复率，Gleason评分和术后住院时间。当P<0.05时,认为差异显著。
结果：CTP组的手术时间更短（109.63minvs.143.20分钟；P<0.001）。CTP组EBL为178.26±30.70mL,在标准前列腺切除术组中，为347.78±53.53mL(P<0.001)。术后住院时间无显著差异，尿失禁的恢复率，观察两组导管插入时间和阳性手术切缘。所有患者均未发生术中并发症。经过6个月的随访，两组的术后可检测前列腺特异性抗原相似.
结论：CTP是可行的，安全,和EP-RARP中的有效程序。CTP的应用改善了前列腺的暴露，与常规手术相比，减少了手术时间和失血量。
