Every setback is a setup for a comeback: 3D laparoscopic radical prostatectomy after robotic radical prostatectomy.

腹腔镜前列腺根治术 医学 前列腺切除术 围手术期 腹腔镜检查 泌尿科 机械人手术 外科 导管 腹腔镜手术 显著性差异 普通外科 前列腺癌 癌症 内科学
作者
Iulia Andraș,Nicolae Crișan,Maxim Gavrilita,Radu-Tudor Coman,Viktoria Nyberg,Ioan Coman
出处
期刊:PubMed 卷期号:22 (1): 87-93 被引量:5
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To assess whether previous experience in robotic surgery has a role in the transition to 3D laparoscopy and influences the perioperative results and short term oncological and functional outcomes of the first patients that undergo laparoscopic radical prostatectomy (LRP).We analyzed 248 patients that underwent robotic radical prostatectomy (RALP) between 2009-2015 and 98 patients that underwent 3D HD LRP from 2015-present in our department. The procedures were performed by the same two surgeons, who crossed from open to robotic surgery, and afterwards to 3D laparoscopy.The patients in the study groups were comparable in terms of age, pre-operative PSA levels, clinical staging and D'Amico risk groups. The operative time was significantly shorter in favor of the laparoscopic approach (a difference of 110 min, p<0.0001). The overall rate of positive surgical margins was similar, with the biggest difference from 40.8% to 25% in pT3 patients in favor of the laparoscopic approach. The mean time to catheter removal was 7 days for RALP and 8 days for LRP. We did not identify any significant difference between the two groups in terms of biochemical recurrence, continence or potency at 3 and 6 months after the procedure.Previous experience in robotic surgery ensured a fast transition to 3D laparoscopic approach for radical prostatectomy, with comparable oncologic and functional outcomes, but with a shorter operative time and reduced costs.

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