Abstract：
BACKGROUND: Minimally invasive techniques have demonstrated several advantages over the open approach. In the field of prostate cancer, the LAP-01 trial demonstrated the superiority of robotic-assisted radical prostatectomy (RARP) over laparoscopic radical prostatectomy (LRP) when comparing continence at 3-month after surgery, with no statistically significant differences at 6 and 12 months of follow-up.
OBJECTIVE: Externally validate the LAP-01 study and compare functional outcomes between the two minimally invasive approaches.
METHODS: This retrospective study, conducted by a single surgeon (MRB), utilized data from a prospectively collected database, which included patients who underwent both RARP or LRP. Data regarding baseline characteristics, continence (assessed through the 24-h Pad test and ICIQ questionnaire) and potency were collected at multiple time points: 1 and 6 weeks after catheter removal, 3-, 6-, and 12-months post-surgery.
RESULTS: The study encompasses 601 patients, 455 who underwent LRP and 146 RARP. The median age at diagnosis was 64 for LRP and 62 for RARP, while the median PSA levels at diagnosis were 6.7 ng/mL for LRP and 6.5 ng/mL for RARP. Bilateral nerve-sparing procedures were performed in 34.07 % of LRP cases and 51.37 % of RARP cases. RARP exhibited a significant advantage over LRP both in continence and potency. Continence rates at 3-, 6- and 9-month after radical prostatectomy (RP) were 36.43 %, 61.86 % and 79.87 % for LRP, compared to 50.98 %, 69.87 % and 91.69 % for RARP. Potency rates at the same intervals were 0.90 %, 3.16 % and 6.39 % for LRP, and 6.19 %, 9.16 % and 18.96 % for RARP. These rates were more pronounced in patients with bilateral nerve-sparing.
CONCLUSIONS: Our study demonstrates that RARP results in significantly better continence recovery and superior potency outcomes throughout the entire follow-up period compared to LRP, even at the beginning of the robotic approach learning curve.
OBJECTIVE: Externally validate the LAP-01 study and compare functional outcomes between the two minimally invasive approaches.
METHODS: This retrospective study, conducted by a single surgeon (MRB), utilized data from a prospectively collected database, which included patients who underwent both RARP or LRP. Data regarding baseline characteristics, continence (assessed through the 24-h Pad test and ICIQ questionnaire) and potency were collected at multiple time points: 1 and 6 weeks after catheter removal, 3-, 6-, and 12-months post-surgery.
RESULTS: The study encompasses 601 patients, 455 who underwent LRP and 146 RARP. The median age at diagnosis was 64 for LRP and 62 for RARP, while the median PSA levels at diagnosis were 6.7 ng/mL for LRP and 6.5 ng/mL for RARP. Bilateral nerve-sparing procedures were performed in 34.07 % of LRP cases and 51.37 % of RARP cases. RARP exhibited a significant advantage over LRP both in continence and potency. Continence rates at 3-, 6- and 9-month after radical prostatectomy (RP) were 36.43 %, 61.86 % and 79.87 % for LRP, compared to 50.98 %, 69.87 % and 91.69 % for RARP. Potency rates at the same intervals were 0.90 %, 3.16 % and 6.39 % for LRP, and 6.19 %, 9.16 % and 18.96 % for RARP. These rates were more pronounced in patients with bilateral nerve-sparing.
CONCLUSIONS: Our study demonstrates that RARP results in significantly better continence recovery and superior potency outcomes throughout the entire follow-up period compared to LRP, even at the beginning of the robotic approach learning curve.
摘要：
背景：微创技术已证明优于开放式方法。在前列腺癌领域，LAP-01试验证明了机器人辅助前列腺癌根治术（RARP）优于腹腔镜前列腺癌根治术（LRP）。随访6个月和12个月时无统计学差异。
目的：从外部验证LAP-01研究并比较两种微创方法的功能结果。
方法：本回顾性研究，由一名外科医生（MRB）进行，利用来自预期收集的数据库的数据，其中包括同时接受RARP或LRP的患者。有关基线特性的数据，在多个时间点收集尿失禁（通过24小时Pad测试和ICIQ问卷评估）和效力：拔除导管后1和6周，3-,6-，术后12个月.
结果：该研究包括601名患者，455人接受了LRP和146RARP。LRP诊断时的中位年龄为64岁，RARP为62岁，而诊断时LRP和RARP的PSA中位数分别为6.7ng/mL和6.5ng/mL。在34.07％的LRP病例和51.37％的RARP病例中进行了双侧神经保留手术。RARP在节制和效力方面均比LRP具有明显优势。延续率在3-，根治性前列腺切除术（RP）后6个月和9个月的发生率为36.43％，LRP为61.86%和79.87%，与50.98%相比，RARP为69.87%和91.69%。相同间隔的效力率为0.90%，LRP为3.16%和6.39%，和6.19%，RARP为9.16%和18.96%。这些比率在双侧保留神经的患者中更为明显。
结论：我们的研究表明，与LRP相比，在整个随访期间，RARP可显著改善患者的节制恢复，并具有更高的效力。甚至在机器人方法学习曲线的开始。
目的：从外部验证LAP-01研究并比较两种微创方法的功能结果。
方法：本回顾性研究，由一名外科医生（MRB）进行，利用来自预期收集的数据库的数据，其中包括同时接受RARP或LRP的患者。有关基线特性的数据，在多个时间点收集尿失禁（通过24小时Pad测试和ICIQ问卷评估）和效力：拔除导管后1和6周，3-,6-，术后12个月.
结果：该研究包括601名患者，455人接受了LRP和146RARP。LRP诊断时的中位年龄为64岁，RARP为62岁，而诊断时LRP和RARP的PSA中位数分别为6.7ng/mL和6.5ng/mL。在34.07％的LRP病例和51.37％的RARP病例中进行了双侧神经保留手术。RARP在节制和效力方面均比LRP具有明显优势。延续率在3-，根治性前列腺切除术（RP）后6个月和9个月的发生率为36.43％，LRP为61.86%和79.87%，与50.98%相比，RARP为69.87%和91.69%。相同间隔的效力率为0.90%，LRP为3.16%和6.39%，和6.19%，RARP为9.16%和18.96%。这些比率在双侧保留神经的患者中更为明显。
结论：我们的研究表明，与LRP相比，在整个随访期间，RARP可显著改善患者的节制恢复，并具有更高的效力。甚至在机器人方法学习曲线的开始。
