Abstract：Objective:To evaluate the efficiency and safety of robotic-assisted laparoscopic radical prostatectomy (RALP ).Methods:We retrospectively reviewed the complete clinical and follow-up data of 187 cases.Results:All 187 cases received successful operation. Average operative time was 149.5 min with an estimated blood loss of 178 ml. The foley catheter was removed on postoperative day 10. 14 cases needed transfusion. One case sustained rectal injury, one met abdominal artery injury. One case suffered sudden cardiac death 6 days after operation. 34 cases were found urinary leakage. The positive surgical margin rate was 33.87%. Pelvic lymph node dissection was introduced to 37 high-risk cases. 182 cases were offered nerve-sparing surgery. 3 cases developed anastomotic stricture, 2 cases requiring dilatation and 1 case need transurethral resection. The continence rate was 94.63% within 2 years. The potency rate was 83.33%. Biochemical recurrence rate was 4.84%.Conclusions:Robotic-assisted laparoscopic radical prostatectomy is safe and reliable, with advantage of shorter hospitalization, less blood loss. It can dispose the slight anatomic structure precisely, which has good perspective.
[1]Sriprasad S, Feneley MR, Thompson PM. History of prostate cancer treatment. Surg Oncol, 2009, 18(3):185-191. [2]Patel VR, Thaly R, Shah K. Robotic radical prostatectomy: outcomes of 500 cases. BJU Int, 2007, 99(5):1109-1112. [3]Dasgupta P, Kirby RS. Outcomes of robotic assisted radical prostatectomy. Int J Urol, 2009,16:244-248. [4]Thorsteinsdottir T, Stranne J, Carlsson S, et al. LAPPRO: a prospective multicentre comparative study of robot-assisted laparoscopic and retropubic radical prostatectomy for prostate cancer. Scand J Urol Nephrol, 2011,45(2):102-112. [5]Lavery HJ, Nabizada-Pace F, Carlucci JR, et al. Nerve-sparing robotic prostatectomy in preoperatively high-risk patients is safe and efficacious. Urol Oncol, 2012,30(1):26-32. [6]Kaul S, Menon M. Robotic radical prostatectomy: evolution from conventional to VIP. World J Urol, 2006,24(2):152-160. [7]Lavery HJ, Thaly R, Albala D, et al. Robotic equipment malfunction during robotic prostatectomy: a multi-institutional study. J Endourol, 2008,22(9):2165-2168. [8]Joseph JV, Vicente I, Madeb R, et al. Robot-assisted vs pure laparoscopic radical prostatectomy: are there any differences? BJU Int, 2005,96(1):39-42. [9]Philippou P, Waine E, Rowe E. Robot-assisted laparoscopic prostatectomy versus open: comparison of the learning curve of a single surgeon. J Endourol, 2012,26(8):1002-1008. [10]Altamar HO, Herrell SD. The current status of robot-assisted laparoscopic prostatectomy. Curr Opin Urol, 2010,20(1):56-59. [11]Artibani W, Fracalanza S, Cavalleri S, et al. Learning curve and preliminary experience with da Vinci-assisted laparoscopic radical prostatectomy. Urol Int, 2008,80(3):237-244. [12]Greco F, Hoda MR, Wagner S, et al. Bilateral vs unilateral laparoscopic intrafascial nerve-sparing radical prostatectomy: evaluation of surgical and functional outcomes in 457 patients. BJU Int, 2011,108(4):583-587. [13]Zorn KC, Gofrit ON, Orvieto MA, et al. Robotic-assisted laparoscopic prostatectomy: functional and pathologic outcomes with interfascial nerve preservation. Eur Urol, 2007,51(3):755-762. [14]Prezioso D, Lotti T, Polito M, et al. Neoadjuvant hormone treatment with leuprolide acetate depot 3.75 mg and cyproterone acetate, before radical prostatectomy: a randomized study. Urol Int, 2004,72(3):189-195. [15]Barocas DA, Salem S, Kordan Y, et al. Robotic assisted laparoscopic prostatectomy versus radical retropubic prostatectomy for clinically localized prostate cancer: comparison of short-term biochemical recurrence-free survival. J Urol, 2010,183(3):990-996. [16]Murphy DG, Kerger M, Crowe H, et al. Operative details and oncological and functional outcome of robotic-assisted laparoscopic radical prostatectomy: 400 cases with a minimum of 12 months follow-up. Eur Urol, 2009, 55(6):1358-1366. [17]Wang L, Chung SF, Yip SK, et al. The natural history of voiding function after robot-assisted laparoscopic radical prostatectomy. Urol Oncol, 2011,29(2):177-182. [18]Bivalacqua TJ, Pierorazio PM, Su LM. Open, laparoscopic and robotic radical prostatectomy: optimizing the surgical approach. Surg Oncol, 2009,18(3):233-241. [19]Lotan Y, Cadeddu JA, Gettman MT. The new economics of radical prostatectomy: cost comparison of open, laparoscopic and robot assisted techniques. J Urol, 2004, 172(4 Pt 1):1431-1435. [20]Smith JA Jr, Herrell SD. Robotic-assisted laparoscopic prostatectomy: do minimally invasive approaches offer significant advantages? J Clin Oncol, 2005,23(32):8170-8175.
