Surgical techniques and short-term outcomes of transvesical robot assisted radical prostatectomy
10.3760/cma.j.issn.1000-6702.2019.02.010
- VernacularTitle:经膀胱入路机器人辅助根治性前列腺切除术的短期疗效分析
- Author:
Xiaochen ZHOU
1
;
Bin FU
;
Cheng ZHANG
;
Weipeng LIU
;
Ju GUO
;
Gongxian WANG
Author Information
1. 南昌大学第一附属医院泌尿外科 330006
- Keywords:
Radical prostatectomy;
Robot;
Transvesical approach;
Localized prostate cancer
- From:
Chinese Journal of Urology
2019;40(2):127-131
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce the technique and report our initial experience of transvesical robot assisted radical prostatectomy (TvRARP).Methods From April 2018 to August 2018,10 patients underwent TvRARP performed by a single surgical team were retrospectively reviewed.Preoperative data of patients [aged (58.6 ± 9.4) years,BMI (26.5 ± 3.1) kg/m2,tPSA (19.5 ± 4.1) ng/ml,biopsy Gleason score 6(6-7),prostate volume (33.4 ± 15.8) ml and IIEF-5 score 12 (10-16)] were collected.Preoperative study revealed 8 cases of cT1c,1 case of cT2a and 1 case of cT2b.All patients were continent preoperatively.During the surgical procedure,the bladder was opened,and a circumferential incision was then made around the internal urethral orifice.Initially,posterior dissection of bilateral vas deferens and seminal vesicles was performed,followed by posterior dissection towards apex.Lateral dissection of neurovascular bundles was performed before anterior dissection towards apex.The exposed urethra was transected and specimen was removed.Vesicourethral anastomosis and closure of bladder was performed in a standard way.Results All 10 cases were successfully performed robotically without conversion,transfusion or other major intraoperative or postoperative complications.Postoperative pathology confirmed 6 cases of pT2a,3 cases of pT2b and 1 case of pT2c [median Gleason score 6 (6-7)].One case was reported positive surgical margin.Operative time was (140.5 ± 35.5) mins.Estimated blood loss was (65.5 ± 35.5) ml.Urethral catheter was removed at 7 days postoperatively.Nine patients achieved urinary continence (0 pads) immediately after the removal of urinary catheter,while 1 patient returned to full continence at 2 weeks postoperatively.During a mean follow-up of 3 months (2-4 months),no biochemical recurrence was detected (tPSA ＜ 0.2 ng/ml).At 2 months postoperatively,IIEF-5 score was 11 (8-13) and no statistically difference was made compared with preoperative data (p ＞ 0.05).Conclusions Transvesical approach is a valid alternative of RARP in patients bearing localized low-risk prostate cancer.Tumor control and preservation of erectile function remains to be determined by long term follow-up.
