機械手臂輔助腹腔鏡攝護腺全切除-中國醫藥大學附設醫院單一醫師經驗報告
黃煒軒、謝博帆、林維卿、張菡、吳錫金、張兆祥
中國醫藥大學附設醫院 泌尿部 放射部 病理部
Robotic assisted laparoscopic radical prostatectomy – Experience of a single surgeon in China Medical Universtiy Hospital
Wei-Hsuan Huang, Po-Fan Hsieh, Wei-Ching Lin, Han Chang, His-Chin Wu, Chao-Hsiang Chang
Department of Urology, China Medical University Hospital, Taichung, Taiwan
Department of Urology, Pei-Kang branch, China Medical University Hospital, Taichung, Taiwan
Department of Radiology, China Medical University Hospital, Taichung, Taiwan
Department of Pathology, China Medical University Hospital, Taichung, Taiwan
Purpose: Prostate cancer (PCa) is the most common cancer in males. Robotic assisted laparoscopic radical prostatectomy (RALRP) is a widely used method to treat localized PCa. We share the experience of RALRP by a single surgeon in our institution.
Materials and Methods: This is a retrospective study of patients with PCa undergoing RALRP by CH Chang in China Medical University Hospital from 2012 to 2017. Perioperative outcomes as well as multiparametric magnetic resonance imaging (mpMRI) reports were collected. Continency was defined as using no pads, and potency was defined as being able to intercourse with or without phosphodiesterase 5 inhibitors. We recorded biochemical failure rate, continency and potency outcomes with Kaplan-Meier method. We also evaluated the correlation betwwen pathology staging and MRI staging.
Results: There were 151 patients in our study. The mean±SD age was 66±6.9 years old. The follow-up was six years in the longest time. There were 18 (11%) low risk, 80 (52%) intermediate risk, 49 (32%) high risk, and 4(2%) very high risk patients. There were 27 (17.8%) patients who had biochemical failure and had adjuvant therapy. The margin positive rate was 39%. The 6-year continency rate was 80%. Seventy-six patients underwent nerve-sparing procedure and the 6-year potency rate was 35.5% (27/76). The biochemical failure free rate was 81% in postoperative 6 years. There was significant correlation between pathology staging and MRI image staging (p = 0.023) by bivariate correlation analysis.
Conclusion: The trifecta outcomes were acceptable in a single surgeon with the first 151 cases. Besides, our MRI staging is highly correlated with the pathological outcomes.