robot-assisted laparoscopic prostatectomy: our experience
การผ่าตัดต่อมลูกหมากผ่านกล้องโดยใช้หุ่นยนต์ช่วย: ประสบการณ์ของเรา
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Abstract
Background. Retropubic radical prostatectomy (RPE) is now the gold standard of treatment for locally advanced prostate cancer (PC). However, robot-assisted RPE procedures using the da Vinci system are finding increasing acceptance.
Materials and methods. The authors conducted a prospective study of 60 robot-assisted prostatectomies made at the Clinic of Urology, N.I. Pirogov National Medical Surgical Center, in the period January 2009 to December 2010.
Results. The duration of an operation averaged 230 min; the average amount of blood loss was 200 ml. The mean duration of postoperative analgesia was 2,7 days. That of urinary catheterization was 8.5 days. A normal postoperative course was noted in most cases (88,4 %). Seven patients were found to have 8 (13,3 %) mild and moderate complications. A pathohistological study revealed a positive surgical margin of resection in 21,7 % of the patients, extracapsular tumor growth in 21,7 %, and seminal vesicle invasion in 23,3 %. Tumor-affected regional lymph nodes were detected in 1 (1,7 %) patient. In our observed series, 82 and 93 % of the subjects completely retained urine after 6 and 12 moths, respectively. Throughout the follow-up, erectile function recovered in 7 of the 15 patients undergoing a nerve-sparing surgical procedure.
Conclusion. Postoperative results in our series of interventions are comparable to those obtained in the studies by Russian and foreign colleagues at the early stage of mastering this procedure. By considering a few observations, it is today difficult to say that our study is valid in the context of evidence-based medicine. Estimation of the benefits of robot-assisted laparoscopic prostatectomy calls for long-term multicenter randomized trials.
ภูมิหลัง ในปัจจุบันการผ่าตัดต่อมลูกหมากแบบถอนรากถอนโคนทางหลังกระดูกหัวหน่าว (retropubic radical prostatectomy: RPE) ถือเป็นมาตรฐานระดับทอง (gold standard) ในการรักษามะเร็งต่อมลูกหมากระยะลุกลามเฉพาะที่ (locally advanced prostate cancer: PC) อย่างไรก็ตาม หัตถการ RPE โดยใช้หุ่นยนต์ช่วยผ่าตัดด้วยระบบดาวินชี (da Vinci system) กำลังได้รับการยอมรับเพิ่มขึ้นอย่างต่อเนื่อง
วัสดุและวิธีการ คณะผู้วิจัยได้ทำการศึกษาแบบไปข้างหน้า (prospective study) ในผู้ป่วยที่ได้รับการผ่าตัด
| Reference Key |
nesterov2014onkourologirobot-assisted
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| Authors | ;S. N. Nesterov;V. V. Rogachikov;K. P. Tevlin;A. A. Strat |
| Journal | supportive care in cancer |
| Year | 2014 |
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