| Objective:To evaluate the safety and feasibility of clinical application by comparing the curative effect of robot-assisted laparoscopic radical prostatectomy(RALP)and traditional laparoscopic radical prostatectomy(LRP).Methods:From March 2017 to June 2019,we completed a total of 259 cases of radical prostatectomy(RP).They were ivided into two groups according to different surgical methods.189 patients underwent RALP and 70 patients underwent LRP.Retrospectively analysis clinical data,operative time,ntraoperative blood loss,transfusion rate,surgical complication,postoperative drainage time,catheter removed time,postoperative hospital stay,postoperative urinary control recovery,positive surgical margin(PSM),biochemical recurrence(BCR),hospitalization costs of two surgical methods.The data of the two groups were analyzed by SPSS21.0 statistical software package.Two independent samples t-test was used for comparison between the two groups.The comparison of count data was performed using Chi-square test or Fisher’s Exact test.Result:All the 259 patients underwent radical prostatectomy under general anesthesia.There was no one change to open surgery.There was no significant difference(P>0.05)in the mean age of patients(69.84±7.72 years VS 70.29±7.28years),body mass index(21.68±1.74kg/m2 VS 21.99±2.19kg/m2),preoperative serum total PSA values(13.88±11.25ng/ml VS 12.90±12.75ng/ml),prostate volume(77.50±24.97cm3 VS 76.89±26.00cm3),preoperative Gleason score,and clinical stage between the RALP and LRP groups.The operative time(136.98 ± 52.31 min VS 193.90 ± 47.00min),ntraoperative blood loss(158.36 ± 64.38 ml VS 221.75 ± 99.31ml),postoperative drainage time(6.87±5.14 d VS 8.54±5.71d),postoperative hospital stay(12.72±8.32 d VS 14.78±7.45d)were statistically significant(P<0.05).There was also no significant difference among surgical complication rate(8.5% VS 14.3%),catheter removed time(8.50±4.05 d VS 9.28±4.88d),positive surgical margin rate(16.4% VS 17.1%).Immediate urinary control after removal of the catheter(14.8% VS 5.7%),1-month urinary recovery rate(47.6% VS 31.4%),3-month urinary recovery rate(81.5% VS 70.0%),all of which were statistical differences,in contrast,the urinary recovery rate in 6-mont(92.1% VS 84.3%),12-month(95.5% VS 95.7%)and 24-month(98.8% VS 96.3%)were no statistical difference.The biochemical recurrence rate of the patients who were underwent RALP group was 1.6%,3.7%,7.0% and 14.0% at 3,6,12,24 months respectively,however,the LRP group was 2.9%,5.7%,8.7% and 18.5% at the same time.but there was no significant difference between the two groups.There was also no significant difference among hospitalization costs.Conclusion:RALP can effectivly reduce the difficulty of the surgery,operative time,ntraoperative blood loss,postoperative drainage time,postoperative hospital stay,and improve the patients’ recent urinary control ability.It can improve patients’ quality of life.The short-term oncologic results(PSM and BCR),long-term functional results(urinary control recovery)and prognosis of RALP were similar to LRP,while the long-term oncologic results need to be long time followed up.RALP is safe and feasible for patients with prostate cancer. |
