过去十年中机器人辅助前列腺根治术的结果:转诊中心的系统回顾和展望。

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY International Braz J Urol Pub Date : 2023-11-01 DOI:10.1590/S1677-5538.IBJU.2023.0467
Marcio Covas Moschovas, Carlo Andrea Bravi, Paolo Dell'Oglio, Filippo Turri, Ruben de Groote, Nikolaos Liakos, Mike Wenzel, Christoph Würnschimmel, Fabrizio Di Maida, Federico Piramide, Iulia Andras, Alberto Breda, Alexandre Mottrie, Vipul Patel, Alessandro Larcher
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引用次数: 0

摘要

目的:挽救机器人辅助前列腺癌根治术(S-RARP)近年来在治疗癌症非手术治疗后癌症复发患者方面得到了重视。我们进行了一项系统的文献综述,以评估S-RARP在过去十年中的作用和结果。材料和方法:对2013年1月1日至2023年6月1日期间发表的关于S-RARP结果的文章进行了系统综述。根据PRISMA指南对文章进行筛选,筛选出33项研究。提取数据,包括患者人口统计、手术时间、并发症、功能结果和肿瘤学结果。结果:在33项研究的1630名患者中,放射治疗是最常见的初级治疗(42%)。手术时间从110到303分钟不等,估计失血量在50到745毫升之间。术中并发症发生率为0到9%,而术后并发症发生率在0到90%之间(Clavien 1-5)。控尿率在0到100%之间,有效率在0至66.7%之间。手术切缘阳性率高达65.6%,生化复发率在0~57%之间。该文献基于具有固有局限性的回顾性研究,描述了术中并发症发生率低和出血量小的情况。然而,与主要RARP系列相比,尽管主要治疗类型不同,但效力和失禁率大大降低。仍然需要设计更好的研究来评估长期结果,并单独说明每种初级治疗对挽救治疗的影响。未来的文章应该更具体,并提供更多关于以前的治疗和S-RARP手术技术的细节。
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Outcomes of Salvage Robotic-assisted Radical Prostatectomy in the last decade: systematic review and perspectives of referral centers.

Purpose: Salvage robotic-assisted radical prostatectomy (S-RARP) has gained prominence in recent years for treating patients with cancer recurrence following non-surgical treatments of Prostate Cancer. We conducted a systematic literature review to evaluate the role and outcomes of S-RARP over the past decade.

Material and methods: A systematic review was conducted, encompassing articles published between January 1st, 2013, and June 1st, 2023, on S-RARP outcomes. Articles were screened according to PRISMA guidelines, resulting in 33 selected studies. Data were extracted, including patient demographics, operative times, complications, functional outcomes, and oncological outcomes.

Results: Among 1,630 patients from 33 studies, radiotherapy was the most common primary treatment (42%). Operative times ranged from 110 to 303 minutes, with estimated blood loss between 50 to 745 mL. Intraoperative complications occurred in 0 to 9% of cases, while postoperative complications ranged from 0 to 90% (Clavien 1-5). Continence rates varied (from 0 to 100%), and potency rates ranged from 0 to 66.7%. Positive surgical margins were reported up to 65.6%, and biochemical recurrence ranged from 0 to 57%.

Conclusion: Salvage robotic-assisted radical prostatectomy in patients with cancer recurrence after previous prostate cancer treatment is safe and feasible. The literature is based on retrospective studies with inherent limitations describing low rates of intraoperative complications and small blood loss. However, potency and continence rates are largely reduced compared to the primary RARP series, despite the type of the primary treatment. Better-designed studies to assess the long-term outcomes and individually specify each primary therapy impact on the salvage treatment are still needed. Future articles should be more specific and provide more details regarding the previous therapies and S-RARP surgical techniques.

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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
期刊最新文献
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