Transvesical Retzius-Sparing Versus Standard Robot-Assisted Radical Prostatectomy: A Retrospective Propensity Score-Adjusted Analysis.
Transvesical Retzius-Sparing Versus Standard Robot-Assisted Radical Prostatectomy: A Retrospective Propensity Score-Adjusted Analysis.
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经膀胱保留 Retzius 与标准机器人辅助根治性前列腺切除术：回顾性倾向评分调整分析
DOI：
10.3389/fonc.2021.687010
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发表时间：
2021
影响因子：
4.7
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Deng W;Jiang H;Liu X;Chen L;Liu W;Zhang C;Zhou X;Fu B;Wang G
评估经膀胱保留Retzius的机器人辅助根治性前列腺癌切除术（T-RARP）与标准机器人辅助根治性前列腺癌切除术（S-RARP）治疗局限性前列腺癌（PCa）的安全性和有效性。我们的分析回顾性入组了2017年10月至2020年1月期间接受T-RARP或S-RARP的174例局部PCa患者。所有潜在的基线混杂因素均采用倾向评分匹配（PM）方法（1：1）进行严格限制。在匹配的情况下，比较T-RARP组和S-RARP组的围手术期和功能结局，同时用Kaplan-Meier曲线显示两组的肿瘤结果和功能恢复。最后，在S-RARP和T-RARP组中分别确定了114例和60例符合条件的局部PCa患者。PM后两组的所有基线特征均无显著差异。在匹配队列中，两组均无病例转为开放手术。T-RARP组的平均手术时间更长（p = 0.001），平均住院时间更短（p < 0.001）。两组之间的中位估计失血量和标本Gleason评分无显著差异。T-RARP组中输血、pT 3a疾病、术后并发症和手术切缘阳性的比例也与S-RARP组相当。术后3个月和末次随访时，两组的平均前列腺特异性抗原和中位勃起功能评分无显著差异。T-RARP与S-RARP相比，在拔管时（p < 0.001）和术后3个月（p < 0.001），尿潴留（UC）率显著改善，但两组之间UC恢复的显著差异在末次随访时消失（p = 0.119）。两种手术后生化无复发生存率无显著差异（p = 0.727）。由经验丰富的手进行T-RARP对于选定的临床局限性PCa患者是可行的，与标准方法相比，可以显著改善UC的早期恢复和类似的勃起功能保留，而不会影响肿瘤控制。
To estimate the safety and efficiency of transvesical Retzius-sparing robot-assisted radical prostatectomy (T-RARP) compared with standard robot-assisted radical prostatectomy (S-RARP) for localized prostate cancer (PCa). 174 patients bearing localized PCa and undergoing T-RARP or S-RARP between October 2017 and January 2020 were retrospectively enrolled in our analysis. All potential baseline confounders were strictly restrained with propensity-score matching (PM) method (1: 1). Within the matched setting, the perioperative and functional outcomes were compared between the T-RARP and S-RARP groups, while the oncological results and functional recovery of the two arms were presented with Kaplan-Meier curves. Finally, 114 and 60 eligible patients harbouring localized PCa were identified in the S-RARP and T-RARP group, respectively. No significant differences between the two groups were found in all baseline characteristics after PM. Within the matched cohort, no case was converted to open surgery in either group. The T-RARP group was significantly related to a higher mean operative time (p = 0.001) and shorter median hospital stay length (p < 0.001). There were not significant differences in the median estimated blood loss and specimen Gleason score between the two arms. The proportions of transfusion, pT3a disease, postoperative complication, and positive surgical margin in the T-RARP group were also comparable to that in the S-RARP group. The mean prostate-specific antigen and median erectile functional scores did not differ significantly between the two groups at postoperative 3 months and last follow-up. T-RARP vs. S-RARP had significantly improved urinary continence (UC) rates at the removal of catheter (p < 0.001) and postoperative 3 months (p < 0.001), but the significant difference between the two groups in UC recovery disappeared at last follow-up (p = 0.119). No significant difference in biochemical recurrence-free survival was observed following the two surgeries (p = 0.727). T-RARP by experienced hands was feasible for selected patients with clinically localized PCa, yielding significantly improved early return to UC and similar erectile functional preservation without compromising oncological control when compared with the standard approach.
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影响因子：
23.4
作者：
Dalela, Deepansh;Jeong, Wooju;Menon, Mani
通讯作者：
Menon, Mani
影响因子：
23.4
作者：
Galfano, Antonio;Ascione, Assunta;Bocciardi, Aldo Massimo
通讯作者：
Bocciardi, Aldo Massimo
DOI：
10.1007/s00464-018-6499-z
发表时间：
2019-07-01
影响因子：
3.1
作者：
Asimakopoulos, Anastasios D.;Topazio, Luca;Annino, Filippo
通讯作者：
Annino, Filippo
影响因子：
6.6
作者：
Lee, Jongsoo;Kim, Ha Yan;Rha, Koon Ho
通讯作者：
Rha, Koon Ho
影响因子：
2.1
作者：
Rosen, RC;Riley, A;Mishra, A
通讯作者：
Mishra, A