| Objective To evaluate the efficacy and safety of robot assisted laparoscopic radical prostatectomy and compared with retropubic radical prostatectomy.Methods Between May 2004 and September 2013, a total of 136 con-secutive men with clinically localized prostate cancer underwent radical prostatectomy.124 patients were involved in, with open in 83 and robotic in 41. The clinical data was collected retrospectively and analyzed. Data of these patients, including preoperative parameter, total operation time, blood loss, blood transfusion rate, duration of catheterization, time of postoperative hospital stay, continence and biochemical recurrence was compared.Results All cases were successfully performed,no RALP conversion to open surgery. In preoperative age, PSA, prostate volume, Gleason s core, clinical stage, RALP group and RRP group had no statistical dif ference. The meaning operation time of the RALP group and the RRP gro up was 224.4±78.26 min and 164.7±33.69 min, with significant differ ence (P<0.05). RALP group and RRP group mean intraoperative blood lo ss was 266.3±299.01ml and 659.2±355.70ml. There was statistical dif ference between them (P<0.05). The rates of intraoperative blood tr ansfusion were 19.5% and 85.5%, with significant difference (P<0.05); the mean catheterization time was 16.4±15.86d and 17.9±7.19d, with significant difference (P<0.05);the mean postoperative hospital stay were (27.2±7.41) d and (23.5±8.70) d (P<0.05); The postoperative pos itive margin rates were 24.4% and 9.9%(P<0.05); TMPRSS2:ERG fusion g ene positive rate was 12.9% and 10.8%, the TMPRSS2:ERG fusion gene po sitive rate of both groups is 11.8%; ERG protein positive rate was 14. 3% and 18.2%, the ERG protein positive rate of both groups is 13.3%. 41 cases of RALP group were followed, with no deaths. The six-month, one-year and two-year biochemical recurrence rate were 7.5%,20.6% an d 23.5%. The three-month, six-month, one-year and two-year continence rate was 58.5%,70%,80% and 94.4%.83 cases of RRP group were follo wed. The six-month, one-year, two-year, three-year, four-year and fiv e-year biochemical recurrence rate 13.2%,16.4%,23.3%,36.3%,30.6% and 42.1%. The three-month, six-month, one-year and two-year continence r ate was 55.4%,70%,77.9% and 78.7%. Two patients were dead, of which one died of PCA metastatis and the other died of nasopharynx cancer. In six-month, one-year, two-year biochemical recurrence and continen ce, P values were greater than 0.05, no statistical difference.Conclusions Robot-assisted radical prostatectomy possessed advant ages of less bleeding and faster recovery. In addition, the effect of postoperative oncology and continence was similar to open surgery. H owever, the operation time and positive margin rates is relatively in feriors to open surgery. As the surgery skill matures, the advantages of RALP will be more apparent and RALP also will be applied more wid... |
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