改良耻骨上入路（SAHZU法）机器人辅助前列腺癌根治术

目的探讨改良耻骨上入路（SAHZU法）机器人辅助前列腺癌根治术治疗前列腺癌（RALP）的安全性及效果。 方法回顾性分析2020年1月至2020年8月在我院接受SAHZU-RALP手术的19例前列腺癌患者的临床资料，包括：患者一般资料、围手术期指标、尿控、性功能和并发症等。 结果19例患者均顺利完成手术，无术中并发症或中转开放手术，手术切缘均阴性。平均手术时间为（113±13）min，平均失血量为（47±12）ml。术后中位住院时间（IQR）为3（1~3）d，术后留置Foley导尿管的中位时间（IQR）为7（6~7） d，留置引流管的中位时间（IQR）为1（0~2） d。在早期功能方面，7例患者拔除尿管后可即刻尿控（0~1个垫片/d），术后随访至6个月时，有14例患者可完全尿控，8例患者勃起功能满意（IIEF评分≥18）。 结论采用SAHZU-RALP治疗局限性前列腺癌在技术上是可行的。这项技术只需四个小切口，无需使用特伦德伦伯格（Trendelenburg）体位即可顺利完成手术，对肿瘤根治疗效好，术后尿控恢复满意，并发症少，但需要长期的随访数据，更多的患者以及临床随机对照研究来验证其疗效。

Modified suprapubic approach (SAHZU) for robot-assisted laparoscopic radical prostatectomy

ObjectiveTo explore the safty and effect of the modified suprapubic robot-assisted laparoscopic radical prostatectomy (SAHZU-RALP) in treating prostate cancer. MethodsAll demographics, Perioperative data, complications, functional results and oncologic data of patients who underwent suprapubic SAHZU-RALP from January 2020 to August 2020 were recorded. ResultsNineteen consecutive patients underwent SAHZU-RALP. The mean operative time was (113±13) min. The mean blood loss was (47±12) ml. All cases were completed without intraoperative complications or conversions. The median (IQR) time of postoperative hospitalization was 3(1-3) days. The median (IQR) time with a Foley catheter after surgery was 7(6-7) days. The median (IQR) time with a drainage tube was 1(0-2) day. No patient had positive surgical margins and postoperative complications. On early functional outcomes, 7 patients had instant urinary control (0-1 pads/day) when the Foley catheter were removed. Fourteen patients were recorded as full urinary control and 8 patients had erectile satisfaction for intercourse (IIEF score≥18) 6 months after surgery. ConclusionsSAHZU-RALP is technically feasible for patients with organ-confined prostate cancer. In our experience, potential advantages were founded including four small incisions, no Trendelenburg position and minor postoperative complications. But long-term follow-up data, more patients and clinical randomized controlled trials are needed to verify its efficacy.