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首页> 外文期刊>Surgical Endoscopy >Retzius-sparing versus standard robot-assisted radical prostatectomy: a prospective randomized comparison on immediate continence rates
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Retzius-sparing versus standard robot-assisted radical prostatectomy: a prospective randomized comparison on immediate continence rates

机译：Retzius - 备用与标准机器人辅助的自由基前列腺切除术：立即欧洲持续率的预期随机比较

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BackgroundPost-prostatectomy urinary incontinence is an adverse event leading to significant distress. Our aim was to evaluate immediate urinary continence (UC) recovery in a single-surgeon prospective randomized comparative study between the traditional robot-assisted laparoscopic radical prostatectomy (TR-RALP) and the Retzius-sparing RALP (RS-RALP), for the treatment of the clinically localized prostate cancer (PCa).Methods102 consecutive PCa patients were prospectively randomized to TR-RALP (57) or RS-RALP (45). Postoperative continence was defined as patient-reported absence of leakage or use of 0 pads/day. The immediate continence rate and 95% confidence interval (CI 95%) were calculated for each treatment. Univariable and multivariate logistic regressions were used to assess predictors of immediate continence following RALP. Continence rates from 1 to 6 months were calculated by Kaplan-Meier curves; log-rank test was used for the curve comparison. Two analyses were performed, considering a per-protocol (PP) population regarding all randomized patients that received nerve-sparing RALP and an Intention-To-Treat (ITT) population regarding all randomized patients that received RALP.ResultsIn the PP analysis, the rates of immediate continence were 12/40 (30%) (CI 95% 17-47%) for the TR-RALP and 20/39 (51.3%) (CI 95% 35-68%) for the RS-RALP (p=0.05). In the ITT analysis, the corresponding rates were 12/57 (21%) (CI 95% 11-34%) for the TR-RALP and 23/45 (51%) (CI 95% 36-66%) for the RS-RALP (p=0.001). Median time to continence was 21 days for the TR-RALP and 1day for RS-RALP, respectively (p=0.02). The relative Kaplan-Meier curves regarding continence resulted statistically different when compared with the log rank test (p=0.02). In the multivariate analysis, lower age and the Retzius-sparing approach were significantly associated to earlier continence recovery.ConclusionsThe Retzius-sparing approach significantly reduces time to continence following RALP. Further studies are required to confirm the reproducibility of our results and investigate the role of the RS-RALP as an additional protective factor for postoperative continence in the elderly population.
机译：背景暴露 - 前列腺切除术尿失禁是一种不良事件，导致显着困扰。我们的目标是在传统的机器人辅助腹腔镜自由基前列腺切除术（TR-RALP）和Retzius - 备用RALP（RA-RALP）之间的单外科医生前瞻性随机对比研究中评估立即泌尿牛奶（UC）恢复。治疗在临床局部化的前列腺癌（PCA）.Methods102连续的PCA患者对Tr-RALP（57）或RS-RALP（45）进行了前瞻性随机。术后持续的肺被定义为患者报告的泄漏或使用0垫/天。为每种治疗计算直接持续率和95％置信区间（CI 95％）。非变性和多变量的逻辑回归用于评估RALP之后立即持续的预测因子。由Kaplan-Meier曲线计算1至6个月的欧洲州;日志秩测试用于曲线比较。考虑到关于所有随机患者的每种协议（PP）人群，有关接受神经滥用的患者的所有议定书（PP），有关接受RALP的所有随机性患者的有意治疗（ITT）人群，则TR-RALP的TRA-RALP和20/39（51.3％）（CI 95％）（CI 95％35-68％）的TR-RALP（P = 0.05）。在ITT分析中，对于TR-RALP和23/45（51％）（CI 95％36-66％），相应的速率为12/57（21％）（CI 95％11-34％（51％）（CI 95％36-66％） -RALP（p = 0.001）。 TR-RALP和1天为RALP的中位时间为21天，分别为RS-RALP（P = 0.02）。与日志等级测试相比（P = 0.02）相比，关于欧洲欧尔的相对Kaplan-Meier曲线导致统计学不同（p = 0.02）。在多变量分析中，较低的年龄和Retzius - 备用方法与早期的持续恢复显着相关。控制措施的抑制方法明显减少了RALP之后的持续时间。需要进一步的研究来确认我们的结果的可重复性，并调查RS-RALP作为老年人术后持续的保护因素的作用。

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