Robot-assisted laparoscopic radical prostatectomy （RALRP） using the da Vinci surgical system is now in widespread use in many countries where economic conditions allow the installation of this expensive technology. ...Robot-assisted laparoscopic radical prostatectomy （RALRP） using the da Vinci surgical system is now in widespread use in many countries where economic conditions allow the installation of this expensive technology. Controversy has surrounded the procedure since it was first performed in 2000, with many critics highlighting the lack of evidence to support its use. However, despite the lack of level I evidence, many large studies of patients have confirmed that the procedure is feasible and safe, with low morbidity. Available longer-term oncological data seem to show that outcomes from the robotic approach at least match those of traditional open radical prostatectomy. Functional outcomes also seem satisfactory, although randomized controlled trials are lacking. This paper reviews the current status of RALRP with respect to perioperative data and complications and oncologic and functional outcomes.展开更多
The interposition sural nerve graft has been attempted occasionally during radical prostatectomy for the recovery of continence and erectile function;however, nerve autograft may result in adverse events for the patie...The interposition sural nerve graft has been attempted occasionally during radical prostatectomy for the recovery of continence and erectile function;however, nerve autograft may result in adverse events for the patient. Here, we present our initial experiences using NerbridgeTM, a novel conduit for peripheral nerve regeneration, rather than utilizing sural nerve grafting, in robot-assisted laparoscopic radical prostatectomy to overcome autograft problems such as prolongation of operation time and postoperative abnormal sensation. This novel artificial conduit interposition can be technically feasible when combined with robotic surgery, and prospective randomized controlled trials with high patients-numbers and long follow-up periods are warranted.展开更多
Robot-assisted radical prostatectomy （RARP） is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the ...Robot-assisted radical prostatectomy （RARP） is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the acceptance of this technology in Europe and the rest of the world has been somewhat slower. This article reviews the current literature on RARP with regard to oncological, continence and potency outcomes-the so-called ＇trifecta＇. Preliminary data appear to show an advantage of RARP over open prostatectomy, with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most studies show good postoperative continence and potency with RARP; however, this needs to be viewed in the context of the paucity of randomized data available in the literature. There is no definitive evidence to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging. Finally, evolving techniques of single-port robotic prostatectomy, laser- guided robotics, catheter-free prostatectomy and image-guided robotics are discussed.展开更多
目的比较达芬奇机器人辅助直肠癌根治术与腹腔镜辅助直肠癌根治术的治疗效果。方法回顾性分析2017年10月—2019年10月行达芬奇机器人或腹腔镜辅助直肠癌根治术的180例患者的临床资料。采用SPSS 22.0软件对患者进行1∶1倾向性评分匹配(PS...目的比较达芬奇机器人辅助直肠癌根治术与腹腔镜辅助直肠癌根治术的治疗效果。方法回顾性分析2017年10月—2019年10月行达芬奇机器人或腹腔镜辅助直肠癌根治术的180例患者的临床资料。采用SPSS 22.0软件对患者进行1∶1倾向性评分匹配(PSM),最终将行达芬奇机器人辅助直肠癌根治术(达芬奇机器人组)、腹腔镜辅助直肠癌根治术(腹腔镜组)患者各51例纳入本研究。比较2组术中及术后情况,分析2组2年生存情况。结果达芬奇机器人组手术时间长于腹腔镜组,术中失血量、术后24 h C反应蛋白及疼痛数字评分法评分低于腹腔镜组,术后拔尿管时间短于腹腔镜组,差异均有统计学意义(P<0.05)。达芬奇机器人组术后并发症发生率为13.73%,腹腔镜组为15.69%,差异无统计学意义(P>0.05)。达芬奇机器人组、腹腔镜组中位生存时间分别为21.9、21.7个月,差异无统计学意义(χ^(2)=0.495,P=0.482)。达芬奇机器人组2年生存率为82.35%(42/51),腹腔镜组为76.47%(39/51),差异无统计学意义(χ^(2)=0.540,P=0.463)。结论达芬奇机器人辅助直肠癌根治术的根治效果、远期疗效与腹腔镜辅助直肠癌根治术相近,但前者更有利于降低术中失血量,缓解术后炎症及疼痛程度,并可促进患者泌尿功能的恢复。展开更多
文摘Robot-assisted laparoscopic radical prostatectomy （RALRP） using the da Vinci surgical system is now in widespread use in many countries where economic conditions allow the installation of this expensive technology. Controversy has surrounded the procedure since it was first performed in 2000, with many critics highlighting the lack of evidence to support its use. However, despite the lack of level I evidence, many large studies of patients have confirmed that the procedure is feasible and safe, with low morbidity. Available longer-term oncological data seem to show that outcomes from the robotic approach at least match those of traditional open radical prostatectomy. Functional outcomes also seem satisfactory, although randomized controlled trials are lacking. This paper reviews the current status of RALRP with respect to perioperative data and complications and oncologic and functional outcomes.
文摘The interposition sural nerve graft has been attempted occasionally during radical prostatectomy for the recovery of continence and erectile function;however, nerve autograft may result in adverse events for the patient. Here, we present our initial experiences using NerbridgeTM, a novel conduit for peripheral nerve regeneration, rather than utilizing sural nerve grafting, in robot-assisted laparoscopic radical prostatectomy to overcome autograft problems such as prolongation of operation time and postoperative abnormal sensation. This novel artificial conduit interposition can be technically feasible when combined with robotic surgery, and prospective randomized controlled trials with high patients-numbers and long follow-up periods are warranted.
文摘Robot-assisted radical prostatectomy （RARP） is a rapidly evolving technique for the treatment of localized prostate cancer. In the United States, over 65% of radical prostatectomies are robot-assisted, although the acceptance of this technology in Europe and the rest of the world has been somewhat slower. This article reviews the current literature on RARP with regard to oncological, continence and potency outcomes-the so-called ＇trifecta＇. Preliminary data appear to show an advantage of RARP over open prostatectomy, with reduced blood loss, decreased pain, early mobilization, shorter hospital stay and lower margin rates. Most studies show good postoperative continence and potency with RARP; however, this needs to be viewed in the context of the paucity of randomized data available in the literature. There is no definitive evidence to show an advantage over standard laparoscopy, but the fact that this technique has reached parity with laparoscopy within 5 years is encouraging. Finally, evolving techniques of single-port robotic prostatectomy, laser- guided robotics, catheter-free prostatectomy and image-guided robotics are discussed.
文摘目的比较达芬奇机器人辅助直肠癌根治术与腹腔镜辅助直肠癌根治术的治疗效果。方法回顾性分析2017年10月—2019年10月行达芬奇机器人或腹腔镜辅助直肠癌根治术的180例患者的临床资料。采用SPSS 22.0软件对患者进行1∶1倾向性评分匹配(PSM),最终将行达芬奇机器人辅助直肠癌根治术(达芬奇机器人组)、腹腔镜辅助直肠癌根治术(腹腔镜组)患者各51例纳入本研究。比较2组术中及术后情况,分析2组2年生存情况。结果达芬奇机器人组手术时间长于腹腔镜组,术中失血量、术后24 h C反应蛋白及疼痛数字评分法评分低于腹腔镜组,术后拔尿管时间短于腹腔镜组,差异均有统计学意义(P<0.05)。达芬奇机器人组术后并发症发生率为13.73%,腹腔镜组为15.69%,差异无统计学意义(P>0.05)。达芬奇机器人组、腹腔镜组中位生存时间分别为21.9、21.7个月,差异无统计学意义(χ^(2)=0.495,P=0.482)。达芬奇机器人组2年生存率为82.35%(42/51),腹腔镜组为76.47%(39/51),差异无统计学意义(χ^(2)=0.540,P=0.463)。结论达芬奇机器人辅助直肠癌根治术的根治效果、远期疗效与腹腔镜辅助直肠癌根治术相近,但前者更有利于降低术中失血量,缓解术后炎症及疼痛程度,并可促进患者泌尿功能的恢复。
