3D laparoscopic salvage radical prostatectomy: mini-series report and review of the literature.

Vlad Horia Schitcu, Mira Florea, Nucu Alexandru Marica, Ioan-Catalin Vlad, Ion Cojocaru, Vlad Munteanu, Paul Kubelac, Mihnea Bogdan Borz
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Abstract

Purpose: Salvage therapy represents a rescue therapy, given after the first line of treatment had failed.The purpose of this study was to review the outcomes of patients who underwent salvage laparoscopic radical prostatectomy (sLRP) in our department and to review current published studies.

Methods: Our mini-series consisted of 6 patients with recurrent prostate cancer(PCa) after non-surgical primary treatment. All interventions were performed by a single surgeon from the Oncological Institute "Prof. Dr. Ion Chiricuta" Cluj Napoca, Romania.A literature review was carried out in June 2020 using the PubMed and MEDLINE databases to identify relevant studies published in the literature between 2000 and 2020. Six papers were selected for our review.We reviewed the oncological and functional outcomes of patients that underwent sLRP.

Results: Extraperitoneal sLRP was performed in 6 patients. Biochemical failure after primary treatment developed between one and five years. Mean operative time was 135.5 min, mean blood loss was 328 ml. No intraoperative complications occurred and no conversions to open surgery. R0 was achieved in 5 out of the 6 patients (83.5%). Out of the 6 patients 2 are incontinent.

Conclusions: SLRP remains an underused procedure and a missed therapeutic opportunity for selected patients. From published data and personal experience, we conclude that in experienced hands sLRP for localized prostate cancer is a feasible, safe and efficient method to treat recurrent PCa. Short-term oncological outcomes are optimistic but further studies need to be made to observe the long-term outcomes.

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三维腹腔镜根治性前列腺切除术:迷你系列报告和文献回顾。
目的:抢救性治疗是指在第一线治疗失败后进行的抢救性治疗。本研究的目的是回顾在我科接受挽救性腹腔镜前列腺根治术(sLRP)的患者的结果,并回顾目前已发表的研究。方法:我们的迷你系列包括6例经非手术治疗的复发性前列腺癌症(PCa)患者。所有干预措施均由罗马尼亚Cluj Napoca肿瘤研究所“Ion Chiricuta教授博士”的一名外科医生进行。2020年6月,使用PubMed和MEDLINE数据库进行了文献综述,以确定2000年至2020年间发表在文献中的相关研究。我们挑选了六篇论文进行审查。我们回顾了接受sLRP的患者的肿瘤学和功能结果。结果:6例患者行腹膜外sLRP。初次治疗后的生化衰竭发生在一到五年之间。平均手术时间为135.5分钟,平均失血量为328毫升。没有发生术中并发症,也没有转为开放手术。6例患者中有5例(83.5%)达到R0,其中2例大小便失禁。结论:对于选定的患者来说,SLRP仍然是一种未充分利用的手术,也是一种错失的治疗机会。根据已发表的数据和个人经验,我们得出结论,在经验丰富的人手中,sLRP治疗局限性前列腺癌症是一种可行、安全和有效的治疗复发性前列腺癌的方法。短期肿瘤学结果是乐观的,但需要进行进一步的研究来观察长期结果。
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