大陸與台灣臨床指引於機器手臂輔助腹腔鏡攝護腺根除手術之比較
盧致誠 范文宙
奇美醫療財團法人柳營奇美醫院 外科部 泌尿外科
Variations of clinical practice guidelines between china and taiwan in robot-assisted laparoscopic radical prostatectomy
Chih-Cheng Lu, Wen-Chou Fan
Division of Urology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan
Purpose:
To explore the role of robot-assisted Laparoscopic radical prostatectomy (RALP) from the documented clinical practice guidelines (CPGs) between China and Taiwan.
Materials and Methods:
The printed and online materials in guidelines for PCa from China and Taiwan were analyzed. We focused on the RALP treatment for PCa.
Results:
The online guidelines for PCa by Chinese Urological Association (CUA) were available in 2011(since 2007 as the first version). Taiwanese first version was available by Taiwan Cooperation Oncology Group (TCOG) PCa practice guidelines in 1999, the second edition in 2003, and the third edition in 2010. Normal range of prostate specific antigen (PSA) is defined from Chinese people data with age specific consideration in CUA, but not in TCOG. PCa Staging by AJCC 2002 is noted in CUA but by AJCC 2010 (the seventh edition) in TCOG. In treatment, RALP takes the advantage of less blood loss and blood transfusion rate compared with traditional approach in both CPGs. Some significant improvement in postoperative urinary control compared with traditional approach in TCOG but no conclusions in CUA. Better outcome in sexual function from RALP in TCOG but not in CUA. High installment cost is mentioned in both CPGs. No Definite evidence-based level of evidence or grade of recommendation is mentioned in both CPGs.
Conclusion:
There are differences in staging system, merits of RALP treatment between China and Taiwan in CPGs. Also this limited study could do some help for the revision of the CPG in Taiwan. Asian urologists and oncologists are suggested to realize the differences at managing prostate cancer patients.