耻骨上经膀胱单孔机器人辅助前列腺癌根治术单中心结果初步分析  

Preliminary analysis of single center results about single port suprapubic transvesical robotic assisted radical prostatectomy

作　　者：姜帅 戚宇[1] 陈翔 夏雨 郭剑明 JIANG Shuai;QI Yu;CHEN Xiang;XIA Yu;GUO Jianming(Department of Urology,Zhongshan Hospital,Fudan University,Shanghai,200032,China;Department of Urology,Zhongshan Hospital Wusong Hospital,Fudan University)

机构地区：[1]复旦大学附属中山医院泌尿外科,上海200032 [2]复旦大学附属中山医院吴淞医院泌尿外科

出　　处：《临床泌尿外科杂志》2022年第1期34-36,共3页Journal of Clinical Urology

摘　　要：目的:探讨耻骨上经膀胱单孔机器人辅助前列腺癌根治术(SPSV-RARP)的临床效果并初步评估21例早期前列腺癌患者术后尿控情况。方法:回顾性分析2019年2—12月复旦大学附属中山医院采取SPSVRARP治疗21例早期前列腺癌患者(cT_(1)N_(0)M_(0)~_(c)T_(2c)N_(0)M_(0))的临床资料。患者中位年龄为70岁,前列腺体积中位数为29.55mL,术前前列腺特异性抗原(PSA)中位数为9.82ng/mL。SPSV-RARP手术方式采用单切口进行,建立手术路径后,在机器人辅助腹腔镜下经膀胱完成前列腺根治性切除术,通过膀胱切口取出标本。记录患者围手术期情况并随访患者术后PSA及尿控情况。结果:21例患者行SPSV-RARP均顺利完成。中位手术时间为70min,术中出血量中位数为95mL,术后Gleason评分中位数为7分。患者切缘阳性率0,术后1个月PSA值均<0.02ng/mL。21例患者术后拔除导尿管的中位时间为7d。21例患者中,术后1、4、12和24周的平均每日使用尿垫量分别为1、1、0和0块。结论:SPSV-RARP在技术上是可行的,早期前列腺癌患者SPSV-RARP术后短期内可获得良好的瘤控和尿控效果。Objective:To investigate the clinical effect of single port suprapubic transvesical robotic assisted radical prostatectomy(SPSV-RARP)and to evaluate urinary continence outcomes in 21patients with early prostate cancer.Methods:From February to December 2019,21patients with early prostate cancer(cT_(1)N_(0)M_(0)~_(c)T_(2c)N_(0)M_(0))were enrolled and treated with SPSV-RARP.The median age was 70years,the median prostate volume was 29.55mL,and the median prostate specific antigen(PSA)was 9.82ng/mL.SPSV-RARP was performed through a single incision.After the surgical path was established,the radical prostatectomy was performed via bladder under robot-assisted laparoscopy.Specimens were extracted through bladder incision.The patient's perioperative situation and daily use of pad during follow-up were recorded.Results:All 21SPSV-RARP cases were successfully completed.The median operative time was 70min,the median intraoperative blood loss was 95mL,and the median postoperative Gleason's score was 7.The positive rate of pathological sample margin was 0,and PSA value was<0.02ng/mL after 1month of surgery.The catheter was removed 7days after operation in all 21patients.Among the 21patients,the mean daily pads used at 1,4,12and 24weeks postoperatively were 1,1,0 and 0,respectively.Conclusion:SPSV-RARP is feasible and can achieve good effects on tumor control and urinary continence in patients with early stage prostate cancer.

关 键 词：前列腺癌 单孔机器人 经膀胱 瘤控 尿控 

分 类 号：R737.25[医药卫生—肿瘤]