Abstract：
OBJECTIVE: Transurethral resection of the prostate (TURP) is one of the surgical options for treating enlarged prostates with lower urinary symptoms (LUTS). In this older group of patients, concomitant prostate cancer is not uncommon. However, the fibrosis and distortion of the prostate anatomy by prior TURP can potentially hinder surgical efficacy at robotic-assisted radical prostatectomy (RARP). We aim to evaluate functional, and oncologic outcomes of RARP in patients with and without previous TURP.
METHODS: 231 men with previous TURP underwent RARP (TURP group). These men were propensity score matched using clinicopathological characteristics to men without previous TURP who underwent RARP (Control group). Perioperative and postoperative variables were analysed for significant differences in outcomes between groups. Variables analysed included estimated blood loss (EBL), operative time, catheter time, hospitalization time, postoperative complications, positive surgical margins (PSM) rates, cancer status, biochemical recurrence (BCR), potency, and continence rates.
RESULTS: Patients in the TURP group showed no statistically significant differences in operative safety measures including median EBL, operative time, catheter time, hospitalization time or postoperative complications. No significant difference between the groups in terms of potency rates and continence rates. Furthermore, there were no statistically significant differences in oncological outcomes, including PSM rates (15% vs 18%, P = 0.3) and BCR.
CONCLUSIONS: In RARP after TURP there is often noticeable distortion of the surgical anatomy. For an experienced team the procedure is safe and provides similar oncologic control and functional outcomes to RARP in patients without previous TURP.
METHODS: 231 men with previous TURP underwent RARP (TURP group). These men were propensity score matched using clinicopathological characteristics to men without previous TURP who underwent RARP (Control group). Perioperative and postoperative variables were analysed for significant differences in outcomes between groups. Variables analysed included estimated blood loss (EBL), operative time, catheter time, hospitalization time, postoperative complications, positive surgical margins (PSM) rates, cancer status, biochemical recurrence (BCR), potency, and continence rates.
RESULTS: Patients in the TURP group showed no statistically significant differences in operative safety measures including median EBL, operative time, catheter time, hospitalization time or postoperative complications. No significant difference between the groups in terms of potency rates and continence rates. Furthermore, there were no statistically significant differences in oncological outcomes, including PSM rates (15% vs 18%, P = 0.3) and BCR.
CONCLUSIONS: In RARP after TURP there is often noticeable distortion of the surgical anatomy. For an experienced team the procedure is safe and provides similar oncologic control and functional outcomes to RARP in patients without previous TURP.
摘要：
目的：经尿道前列腺电切术（TURP）是治疗下尿路症状（LUTS）的前列腺肥大的手术选择之一。在这群老年患者中，伴随的前列腺癌并不少见。然而,之前的TURP导致的前列腺解剖结构纤维化和扭曲可能会阻碍机器人辅助前列腺癌根治术(RARP)的手术疗效.我们的目标是评估功能，和RARP的肿瘤学结果在有和没有以前的TURP患者。
方法：231名既往TURP患者接受了RARP（TURP组）。这些男性使用临床病理特征与没有进行RARP的先前TURP的男性（对照组）进行了倾向评分匹配。分析了围手术期和术后变量在组间结果上的显著差异。分析的变量包括估计失血量(EBL)，手术时间,导管时间,住院时间,术后并发症,手术切缘阳性(PSM)率，癌症状态，生化复发（BCR），效力，效力和节制率。
结果：TURP组患者在手术安全性措施（包括中位EBL）方面无统计学差异，手术时间,导管时间,住院时间或术后并发症。两组之间在效能率和节制率方面没有显着差异。此外，肿瘤结局没有统计学上的显著差异，包括PSM率(15%对18%，P=0.3)和BCR。
结论：在TURP后的RARP中，通常会出现明显的手术解剖结构变形。对于经验丰富的团队，该程序是安全的，并且在没有先前TURP的患者中提供与RARP相似的肿瘤控制和功能结果。
方法：231名既往TURP患者接受了RARP（TURP组）。这些男性使用临床病理特征与没有进行RARP的先前TURP的男性（对照组）进行了倾向评分匹配。分析了围手术期和术后变量在组间结果上的显著差异。分析的变量包括估计失血量(EBL)，手术时间,导管时间,住院时间,术后并发症,手术切缘阳性(PSM)率，癌症状态，生化复发（BCR），效力，效力和节制率。
结果：TURP组患者在手术安全性措施（包括中位EBL）方面无统计学差异，手术时间,导管时间,住院时间或术后并发症。两组之间在效能率和节制率方面没有显着差异。此外，肿瘤结局没有统计学上的显著差异，包括PSM率(15%对18%，P=0.3)和BCR。
结论：在TURP后的RARP中，通常会出现明显的手术解剖结构变形。对于经验丰富的团队，该程序是安全的，并且在没有先前TURP的患者中提供与RARP相似的肿瘤控制和功能结果。
