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首页> 外文期刊>Urologic oncology >Robotic-assisted laparoscopic and radical retropubic prostatectomy generate similar positive margin rates in low and intermediate risk patients.
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Robotic-assisted laparoscopic and radical retropubic prostatectomy generate similar positive margin rates in low and intermediate risk patients.

机译：机器人辅助的腹腔镜和根治性耻骨后前列腺切除术在中低风险患者中产生相似的阳性切缘率。

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OBJECTIVE: Robotic-assisted laparoscopic prostatectomy (RALP) is being increasingly utilized. To assess the efficacy of the operation, we compared apical and overall margin status for RALP with radical retropubic prostatectomy (RRP) in a group of contemporary patients. PATIENTS AND METHODS: We retrospectively reviewed 98 consecutive RRPs and then 94 RALPs from a single institution. Groups were analyzed and matched with regard to preoperative prostate-specific antigen (PSA), cancer grade, pathologic stage, and tumor volume. Surgical margins were quantitated. RESULTS: Clinicopathologic parameters were compared and additional high risk patients were observed in the RRP vs. RALP group. To risk-adjust these patient groups, those meeting preoperative high risk criteria were excluded from further positive margin analysis. Postoperatively, the average tumor volume was 13% in both groups. Pathologic stage pT3 was similar between RRP (14%) and RALP (11%). A positive surgical margin (PSM) was found in 12 cases (14%) after RRP and 11 cases (13%) after RALP including apical margins. Positive margins at the apex, non-apex, and both were statistically similar between groups. CONCLUSIONS: In this study, no differences were seen between robotic prostatectomy with regard to apical or overall margin status compared with open prostatectomy in lower risk patients. This suggests that despite improved visualization, RALP generates a similar margin status as RRP.
机译：目的：越来越多地使用机器人辅助的腹腔镜前列腺切除术（RALP）。为了评估手术的有效性，我们比较了一组当代患者的RALP根尖和总体切缘状态与根治性耻骨后前列腺切除术（RRP）。患者和方法：我们回顾性回顾了来自单个机构的98个连续RRP，然后是94个RALP。对各组进行分析，并就术前前列腺特异性抗原（PSA），癌症等级，病理分期和肿瘤体积进行匹配。量化手术切缘。结果：比较了RRP vs RALP组的临床病理参数并观察到了其他高危患者。为了对这些患者进行风险调整，将符合术前高风险标准的患者排除在进一步的阳性边缘分析之外。术后两组的平均肿瘤体积为13％。 RRP（14％）和RALP（11％）的病理分期pT3相似。 RRP术后12例（14％）和RALP术后11例（13％）（包括根尖切缘）发现阳性切缘（PSM）。两组之间的顶端，非顶端的正切缘和统计学上相似。结论：在本研究中，与低风险患者的开放式前列腺切除术相比，机器人式前列腺切除术在根尖或总体切缘状态方面无差异。这表明，尽管可视化得到了改善，但RALP生成的保证金状态与RRP相似。

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