Robotic Radical Prostatectomy: Operative Technique, Outcomes, and Learning Curve
Robotic Radical Prostatectomy: Operative Technique, Outcomes, and Learning Curve
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机器人根治性前列腺切除术：手术技术、结果和学习曲线
DOI：
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
D. Scherr
中科院分区：
文献类型：
--
作者：
J. Raman;S. Dong;A. Levinson;D. Samadi;D. Scherr
目的：报告我们最初的140多例机器人根治性乳腺癌切除术患者的手术技术、肿瘤学和治疗结局以及学习曲线。方法：2003年1月至2005年5月，143例临床局限性前列腺癌患者接受了机器人根治性前列腺切除术。前瞻性数据收集包括患者年龄、体重指数（BMI）、临床T分期、活检Gleason评分和前列腺特异性抗原（PSA）。手术结局指标包括手术时间、估计失血量（EBL）和并发症。术后结局包括住院时间、导管持续时间、病理学、切缘状态、生化复发和复发。结果：平均手术时间为241分钟，EBL为274 mL。5例患者（3%）需要转为开放手术。平均住院时间为1.8天，Foley导管在8.9天后取出。141例男性中有24例（17%）手术切缘阳性，从我们经验的前半部分的23%下降到后半部分的11%。囊外侵犯患者的手术切缘阳性率明显高于器官局限性疾病患者（47%对15%）。40%以上的阳性切缘位于后方。在平均11个月的随访中，96%的患者PSA<0.2 ng/mL。中位时间为3.5个月，超过95%的患者在1年内完全控制。结论：机器人前列腺癌根治术是治疗临床局限性前列腺癌的有效方法。虽然需要克服学习曲线，但患者在恢复期获益，早期肿瘤学和功能结局与开放式方法相当。需要更长期的结果;然而，我们系列中的患者结果令人鼓舞。
Objective: To report the operative technique, oncologic and therapeutic outcomes, and learning curve from our initial series of over 140 patients treated by robotic radical prostatectomy. Methods: Between January 2003 and May 2005, 143 patients with clinically localized prostate cancer underwent a robotic radical prostatectomy. Prospective data collection included patient age, body mass index (BMI), clinical T stage, biopsy Gleason score, and prostate-specific antigen (PSA). Operative outcome measures included operative time, estimated blood loss (EBL), and complications. Postoperative outcomes were length of hospital stay, catheter duration, pathology, margin status, biochemical recurrence, and return of continence. Results: Mean operative time was 241 minutes with an EBL of 274 mL. Five patients (3%) required conversion to open surgery. The average hospitalization was 1.8 days, and Foley catheters were removed after 8.9 days. Twenty-four of 141 men (17%) had a positive surgical margin, with a decrease from 23% in the first half of our experience to 11% in the latter half. Patients with an extracapsular extension had a significantly higher positive surgical margin rate than did those with organ-confined disease (47% vs 15%). Over 40% of the positive margins were located posteriorly. At a mean follow-up of 11 months, 96% of patients had a PSA<0.2 ng/mL. The median time to complete continence was 3.5 months, and over 95% of patients were fully continent at 1 year. Conclusion: Robotic radical prostatectomy is an effective treatment modality for clinically localized prostate cancer. Although a learning curve needs to be overcome, patients experienced benefits in convalescence with early oncologic and functional outcomes comparable to those of the open approach. Longer-term results are needed; however, patient outcomes in our series are encouraging.
对大型耻骨后前列腺切除术系列中手术切缘阳性发生率降低的评估。
DOI：
10.1097/01.ju.0000098604.09395.27
发表时间：
2004
期刊：
The Journal of urology.
影响因子：
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作者：
Han,Misop;Partin,AlanW;Chan,DavidY;Walsh,PatrickC
通讯作者：
Walsh,PatrickC
影响因子：
2.4
作者：
Han, M;Partin, AW;Walsh, PC
通讯作者：
Walsh, PC