腹腔镜根治性前列腺切除术:单中心经验

B. Shabani, S. Gurmeshevski, G. Petrushevska, S. Dohcev, S. Stavridis, O. Stankov
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引用次数: 0

摘要

包括机器人辅助和腹腔镜根治性前列腺切除术在内的微创技术已成为前列腺癌手术治疗的首选方法。本研究的目的是评估和比较腹腔镜根治性前列腺切除术(LRP)和开放式耻骨后根治性前列腺切除术(ORRP)治疗局限性前列腺癌的安全性、有效性和肿瘤预后。2016年1月至2019年6月,斯科普里泌尿外科大学诊所共进行了123例低风险局部前列腺癌根治性前列腺切除术(RPs)。其中LRP 61例(49.6%),ORRP 62例(50.4%),平均年龄54岁(33 ~ 67岁)。手术指征:前列腺癌病理发现,年龄≤70岁,PSA<10ng/ml, Gleson评分≤7(3+3或3+4),骨显像阴性,分期≤T2a, N0, M0。评估所有患者的人口学数据、PSA水平、Gleason评分、手术时间、LRP转为开放手术、出血量、术中及术后并发症、拔管次数、输血次数、住院时间和肿瘤预后。LRP优于ORRP,手术时间更短,出血量更少(p < 0.5),恢复口服摄入时间更短,术后住院时间更短(p < 0.5),镇痛需求更少。在肿瘤预后方面,我们观察到LRP组的阳性边缘较少(p < 0.5)。我们的研究结果表明,尽管两种手术技术都是安全的,提供了良好的手术质量,但在我们的研究中,LRP在安全性、有效性和肿瘤预后方面更胜一筹。医学杂志,2020;59(3):xx-xx。
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LAPAROSCOPIC RADICAL PROSTATECTOMY: A SINGLE CENTER EXPERIENCE
Minimally invasive techniques including robotic-assisted and laparoscopic radical prostatectomy have become the preferred approach for operative treatment of prostate cancer. The aim of this study was to evaluate and compare results of laparoscopic radical prostatectomy (LRP) and open retropubic radical prostatectomy (ORRP) for localised prostate cancer, in terms of safety, eficacy and oncological outcome. A total of 123 radical prostatectomies (RPs) for low-risk localised prostate cancer were performed between January 2016 and June 2019 at the University Clinic of Urology Skopje. Of these, 61 (49.6%) were LRP and 62 (50.4%) ORRP, mean patients age was 54 years (33 to 67) Indications for operative procedure included: pathohistological finding of prostate cancer, age ≤ 70 years, PSA<10ng/ml, Gleson score ≤ 7 (3+3 or 3+4), negative bone scintigraphy, stage ≤T2a, N0, M0. All patients were assessed regarding the demographic data, PSA level, Gleason score, operative time, conversion to open surgery for LRP, blood loss, intra and post operative complications, catheter removal, number blood transfusion, hospital stay and oncological outcomes. LRP proved superior to ORRP, resulting in shorter operating time, less blood loss (p < 0.5), shorter time to resumption of oral intake, shorter postoperative hospital stay (p < 0.5), and less analgesic requirements. In terms of oncological outcomes, we observed less positive margins in the LRP group (p < 0.5). Our results indicate that although both operative techniques represent safe procedures, offering good qualiy of operation, in our series, LRP was superior in terms of safety, eficacy and oncological outcomes. Acta Medica Medianae 2020;59(3):xx-xx.
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