Robotic-assisted Urethra-sparing Simple Prostatectomy Via an Extraperitoneal Approach
Robotic-assisted Urethra-sparing Simple Prostatectomy Via an Extraperitoneal Approach
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通过腹膜外方法进行机器人辅助保留尿道的简单前列腺切除术
DOI：
10.1016/j.urology.2018.06.005
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发表时间：
2018-09-01
期刊：
影响因子：
2.1
通讯作者：
Wang, Shuo
中科院分区：
文献类型：
--
作者：
Wang, Ping;Xia, Dan;Wang, Shuo
目的介绍一种新颖的机器人辅助保留尿道单纯前列腺切除术（RAUSP）治疗良性前列腺增生症（BPH）的方法。材料与方法2015年4月至2016年12月，27例患者经腹膜外途径行RAUSP。结果26例（96.3%）患者成功行RAUSP，1例（3.7%）患者中转单纯前列腺切除术。中位手术时间为169分钟（四分位距：150-185）;中位估计失血量为235 mL（四分位距：180-300）。7例（26.9%）因意外尿道切开而需要尿道修复。平均导管插入时间为1.6天（范围1-5）。报告了Clavien并发症，6例为低度（1级或2级），1例为3a级并发症（肉眼血尿，需要膀胱冲洗）。平均随访时间为16.4个月（范围9-30）。术后问卷调查显示，国际前列腺症状评分（P < .001）和生活质量评分（P < .001）术后明显改善。结果14例患者均有勃起功能，13例正常射精，1例逆行射精。结论RAUSP治疗良性前列腺增生症是可行的。我们的数据表明，患者有较短的导管插入时间，一个可接受的风险，排尿功能显着改善和维持顺行射精后，这种保留尿道的技术。(C)2018爱思唯尔公司
OBJECTIVE To present an original technique of robotic-assisted urethra-sparing simple prostatectomy (RAUSP) for treating patients with benign prostatic hyperplasia.MATERIALS AND METHODS From April 2015 to December 2016, 27 patients underwent RAUSP via an extraperitoneal approach. Baseline patient characteristics, perioperative outcomes, pathologic outcomes, postoperative Clavien complications, International Prostate Symptom Score, International Index of Erectile Function, and ejaculatory function were assessed.RESULTS Twenty-six patients (96.3%) successfully underwent RAUSP, one patient (3.7%) was converted to simple prostatectomy. Median operative time was 169 minutes (interquartile range: 150-185); median estimated blood loss was 235 mL (interquartile range: 180-300). Seven cases (26.9%) required urethral repair secondary to inadvertent urethrotomy. Mean catheterization time was 1.6 days (range 1-5). Clavien complications were reported, 6 being low grade (grade 1 or 2) with a single 3a complication (gross hematuria requiring bladder irrigation). Mean follow-up duration was 16.4 months (range 9-30). Postoperative questionnaire demonstrated that international prostate symptom score (P < .001) and quality of life score (P < .001) were significantly improved postoperatively. A total of 14 patients reported erectile function, 13 of which had normal ejaculation, only 1 complained retrograde ejaculation.CONCLUSION RAUSP is technically feasible for patients with benign prostatic hyperplasia. Our data indicate that patients have short catheterization time, an acceptable risk profile, significant improvements of voiding function and maintaining antegrade ejaculation following this urethral-sparing technique. (C) 2018 Elsevier Inc.