A comparative study between Retzius-sparing robot-assisted laparoscopic radical prostatectomy and conventional robot-assisted laparoscopic radical prostatectomy

摘要

Objective To compare the postoperative outcomes and early continence rate between conventional robot-assisted laparoscopic radical prostatectomy (RARP) and Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RSRARP). Methods The date from 50 patients who underwent RSRARP and 122 patients who underwent conventional RARP between 2016 September to 2017 included study. Ninety-two patients (forty-six patients in RARP group and forty-six patients in RSRARP group) were collected by propensity-score matching which were performed using eight preoperative variables. Preoperative data of patients in RSRARP group [patients age (67.1±5.7) years, BMI (24.6±2.7)kg/m2, tPSA 10.7 ng/ml (0-40.7 ng/ml), Gleason score 7 points (6-9 points), prostate volume 31.9 ml (10.0-95.4 ml), ECOG score 0 points (0-1 points), urinary domain of EPIC 94.8 points (63.9-100 points), clinical stage from T1cN0M0 to T3aN0M0] and conventional RARP group [patients age (67.2±6.7) years, BMI (25.2±3.1)kg/m2, tPSA 10.7 ng/ml (0-40.7 ng/ml), Gleason score 7 points (6-9 points), prostate volume 36.8 ml (8.9-81.0 ml), ECOG score 0 points (0-1 points), urinary domain of EPIC 95.8 points (63.9-100.0 points), clinical stage from T1cN0M0 to T3aN0M0] had no significant differences. We reviewed console time, estimated blood loss, the rate of leakage, complications, average daily drainage, pathological result, continence, urinary domain of EPIC one month, two months and three months after operation. Results All 92 cases were successfully performed robotically. Mean operation time was significantly more in RARP group than in RSRARP group [(223.9±48.9)min vs. (198.91±34.2)min, P 0.05). Early continence rate one week and one month after surgery was significantly higher in RSRARP group than in RARP group (78% vs. 35%, 91% vs. 79%, P 0.05). Conclusions RSRARP were time-saving, safe and effective for the surgical treatment of localized prostate cancer. It seemed to yield a better outcome regarding early return to urinary continence postoperatively. Key words: Prostatic cancer; Radical prostatectomy; Robot; Retzius space; Continence