机器人辅助完全后入路筋膜内前列腺癌根治术5例经验总结

目的简要介绍机器人辅助完全后入路筋膜内前列腺癌根治术的初步经验。方法回顾性分析浙江大学医学院附属邵逸夫医院泌尿外科2016年8月至10月间5例机器人辅助完全后入路筋膜内前列腺癌根治术患者的临床资料。结果所有手术均顺利完成,手术时间为124~155分钟,平均(139.8±13.9)分钟;术中出血量30~80ml,平均(52.0±19.2)ml。无切缘阳性患者。术后6周复查PSA均达到根治标准。3例患者术后拔除导尿管后即能完全控尿,未使用尿垫,其余2例在术后1个月内控尿完全恢复。2例患者术后1个月内恢复勃起功能,其余3例随访1个月未见明显性功能恢复。结论机器人辅助完全后入路筋膜内前列腺癌根治术是可行的。患者的肿瘤控制、术后尿控以及性功能恢复均较为满意。有条件的单位可选择合适患者施行。

Experience of the Robot-Assisted Laparoscopic Radical Prostatectomy via Completely Posterior and Intrafascial Approach: A Report of 5 Cases

Objective To briefly introduce the initial experience of the robot-assisted laparoscopic radical prostatectomy (RALP) by completely posterior and intrafascial approach.Methods By retrospectively reviewing the clinical data of the 5 cases who received RALP by completely posterior and intrafascial approach between August 2016 and October 2016.Results All these 5 RALP by completely posterior and intrafascial approach were successfully completed.The operation time was between 124 and 155 minutes [(139.8±13.9) minutes on average].The estimated intraoperative blood loss was between 30 to 80 ml [(52.0±19.2) ml on average].No case with positive surgical margin was found.The serum PSA levels decreased to the criteria of radical prostatectomy 6 weeks postoperatively.Three patients were able to fully control their urination, with no need for diapers, and the other two regained full urinary continence within 1 month after surgery.Two patients recovered their erectile function within 1 month after surgery, while the other 3 patients didn't report erection function recover.Conclusions The tumor control, the postoperative urinary continence, and the erectile function recovery of the RALP by completely posterior and intrafascial approach are relatively satisfactory.It is feasible to perform this approach for selected suitable patients.