Objective To investigate the efficacy and safety of modified single incision multi-channel (There is no need to use a multi-channel laparoscopic surgical approach device) extraperitoneal robot-assisted laparoscopic radical prostatectomy. Methods The clinical data of 120 patients with prostate cancer in Sichuan Provincial People's Hospital from November 2020 to June 2021 were analyzed retrospectively. There were 60 cases in group A (modified single incision extraperitoneal approach) and 60 cases in group B (multi-incision transabdominal approach). The average age of group A was 67.5 (60~78) years old. Among them, Gleason score was ≤ 7 in 50 cases and 8 in 10 cases. The volume of prostate was 62.4 (25.0~200.0) ml. The average age of group B was 68.3 (57~80) years. Among them, Gleason score was ≤ 7 in 48 cases and 8 in 12 cases. The volume of prostate was 63.2 (29.5~120.0) ml. The operation time, blood loss, postoperative hospital stay, postoperative exhaust time, incisal margin positive rate and urine control satisfaction rate were compared between the two groups. Results The operation was completed successfully in both groups. The postoperative exhaust time in group A and group B were 25 h (12 h~50 h) and 81.5 h (48 h~160 h), respectively, with statistical difference (P<0.05). The satisfaction rate of urine control in 24 hours and 3 months after operation were 20 cases (accounting for 33.33%), 55 cases (accounting for 91.67%) and 6 cases (accounting for 10.0%), 18 cases (accounting for 30.0%) respectively, the differences were statistically significant (P<0.05). Conclusions Modified single incision and multi-channel extraperitoneal robot-assisted laparoscopic radical prostatectomy has good tumor control effect and rapid recovery of urinary continence and intestinal function after operation. It is not restricted by special PORT and is easy to be popularized.
Key words
Single incision surgery; /
Robot-assisted laparoscopic surgery; /
Extraperitoneal approach /
Prostate cancer; /
/
Radical prostatectomy
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 李磊, 贺大林. 根治性前列腺切除术的规范与挑战[J].现代泌尿外科杂志, 2014,19(8):502-504.DOI: 10.3969/j.issn.1009-8291.2014-08-003.
[2] Sood A, Jeong W, Peabody JO, et al. Robot~assisted radical prostatectomy: inching toward gold standard[J]. Urol Clin North Am, 2014, 41(4):473–484. DOI: 10.1016/j.ucl.2014.07.002.
[3] 周晓晨, 胡兵, 傅斌, 等. 3种机器人辅助腹腔镜根治性前列腺切除术手术入路对比研究:前入路、后入路及经膀胱入路[J]. 临床泌尿外科杂志,2019, 34(7):501-506. DOI: 10.13201/j.issn.1001-1420. 2019. 07. 001.
[4] 陈正军,吕倩,范世达,等.四孔法腹膜外机器人辅助腹腔镜前列腺根治性切除术22例报道[J].机器人外科学杂志(中英文), 2020,1(4):266-270. DOI:10.12180/j.issn.2096-7721.2020. 04.006.
[5] Basiri A, de la Rosette JJ, Tabatabaei S, et al. Comparison of retropubic, laparoscopic and robotic radical prostatectomy: who is the winner[J]? World J Urol, 2018, 36(4):609-621.DOI: 10.1007/s00345-018-2174-1.
[6] Sriprasad S , Feneley MR , Thompson PM . History of prostate cancer treatment[J]. Surg Oncol, 2009, 18(3):185-191. DOI: 10.1016/j.suronc.2009.07.001.
[7] Kaler KS , Vernez SL , Skarecky DW , et al. Outcome measures after robot~assisted radical prostatectomy[J]. Robotic Urology, 2018, 9(5):117-136. DOI: 10.1007/978-3-319-65864-3_37.
[8] 杜巍, 徐伟东, 杨悦, 等.多种路径机器人辅助单孔腹腔镜根治性前列腺切除术的初步疗效[J].中华泌尿外科杂志, 2020, 41(11):815-819. DOI: 10.3760/cma.j.cn112330-20200909-00657.
[9] Pick DL, Lee DI, Skarecky DW, et al. Anatomic guide for port placement for daVinci robotic radical prostatectomy[J]. J Endourol, 2004, 18(6):572-575．DOI: 10.1089/end.2004.18.572.
[10]夏丹, 王平, 秦杰, 等．经腹膜外途径与经腹途径机器人辅助腹腔镜下根治性前列腺切除术的比较分析[J]. 中华泌尿外科杂志, 2016, 37(3):165-168．DOI: 10.3760/cma.j.issn.1000-6702.2016.03.002.
[11]Akand M, Erdogru T, Avci E, et al. Transperitoneal versus extraperitoneal robot~assisted laparoscopic radical prostatectomy: A prospective single surgeon randomized comparative study[J]. Int J Urol, 2015, 22(10):916-921. DOI: 10.1111/iju.12854.
[12]Lai A, Dobbs RW, Talamini S, et al. Single port robotic radical prostatectomy: a systematic review[J]. Transl Androl Urol, 2020, 9(2):898-905. DOI: 10.21037/tau.2019.11.05.
[13]陈恕求, 孙进, 许斌, 等. 前入路保留部分Retzius间隙的机器人辅助腹腔镜根治性前列腺切除术的疗效评价[J].中华泌尿外科杂志, 2020, 41(12):916-920. DOI: 10.3760/cma.j.cn112330-20200820-00612.
[14]高炜, 张雪宁, 郭志, 等. Denonvilliers筋膜的应用解剖学研究进展[J].中国临床解剖学杂志, 2016, 34(1):111-114. DOI: 10.13418/j.issn. 1001-165x.2016.01.028.
PDF(1883 KB)
