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首页> 外文期刊>The Canadian journal of urology >My week at the AUA meeting.
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My week at the AUA meeting.

机译：我在AUA会议上的一周。

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As Miller described, it is how we look at things, including change, that determines our destination. Change is not the real issue, but rather how we evaluate and respond to it. I write this 2 months after our San Diego AUA meeting. Wearing first my program director and then the "laparoscopy and robotics take home messenger" hats, I spent the full week at the AUA this year. And it was only the second time, out of a score of meetings, I felt palpable excitement that something truly unexpected had happened. The first time, Guillonneau and Vallancien shocked us with their Montsouris technique. They had one-upped the Americans by making laparoscopic radical prostatectomy routine and reproducible. Now, 15 years later, we realize it wasn't quite so easy, even after we made LRP robotic. Importantly, how we look at all this technology has changed. A dozen years ago, Dr. Louis Kavoussi stated "For LRP to be an acceptable and reasonable alternative, the oncologic results must be equivalent to the results of RRP, and significant advantages in morbidity (hospital stay, pain, incontinence, impotence) must be attained; otherwise, the steep learning curve and the additional expense of the procedure make it difficult to justify as an alternative therapeutic modality. Besides a reduction in the transfusion rate, no other significant advantages of LRP over radical prostatectomy have been demonstrated definitively to date. As a result, the role of LRP in the management of prostate cancer remains investigational, and patients should be informed appropriately. The oncologic results and low morbidity of nerve-sparing RRP set a high standard for a laparoscopic technique to equal." More recently, other robotic experts have told me they disagree. The outcomes need only be better in any way or potentially even equivalent to justify continuation. Have we seen the significant advantages Dr. Kavoussi deemed necessary to justify? We agree to disagree. Has our failing to define at the outset what comprises "significant advantages" contributed to the laparoscopic and then robotic prostatectomy adoption? Would things have played out differently if we had?
机译：正如米勒（Miller）所说，正是我们如何看待事物（包括变化）决定了我们的目的地。变化不是真正的问题，而是我们如何评估和响应它。我在圣地亚哥AUA会议召开两个月后写这封信。我戴了我的程序主管，然后戴了“腹腔镜和机器人技术带回家的信使”帽子，我今年在AUA呆了整整一周。只是在第二次会议中，我第二次感到非常兴奋，这确实发生了一些意想不到的事情。 Guillonneau和Vallancien第一次用他们的Montsouris技术震惊了我们。他们通过使腹腔镜根治性前列腺切除术成为常规且可重复的方法，使美国人人数增加了一个。 15年后的今天，即使我们使LRP成为机器人，我们也意识到这并不是一件容易的事。重要的是，我们对所有这些技术的看法已经改变。十几年前，路易斯·卡沃西（Louis Kavoussi）博士说：“要使LRP成为可接受且合理的替代方案，其肿瘤学结果必须与RRP的结果相同，并且必须在发病率（住院，疼痛，失禁，阳imp）方面取得显着优势。除了降低输血速度外，迄今为止还没有明确证明LRP优于根治性前列腺切除术的其他显着优势。结果，LRP在前列腺癌管理中的作用仍在研究中，应适当告知患者。保留神经的RRP的肿瘤学结果和低发病率为腹腔镜技术设定了高标准。最近，其他机器人专家告诉我他们不同意。成果只需要以任何方式改善，甚至可能等同于证明继续下去是合理的。我们是否看到过卡沃西博士认为必要的显着优势？我们同意不同意。我们是否一开始就没有定义“显着优势”由什么构成，从而促成了腹腔镜手术和机器人前列腺切除术的采用？如果有的话，事情会有所不同吗？

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