神經血管叢之保留對禁尿功能在對Retzius空間保留之機械手臂根除性
攝護腺切除手術之影響
廖博崎、裘坤元*
臺中榮總外科部泌尿外科*
Continence outcome in Retzius-sparing Robotic-assisted Radical Prostatectomy with Neurovascular bundle preserving
Po-Chi Liao, Kun-Yuan Chiu *
Division of Urology, Department of Surgery, Taichung Veterans General Hospital*
Purpose: Many study has reported better early continence rate and safe oncology control of Retzius-sapring robotic-assisted radical prostatectomy compare to conventional approach. However, immediate continence rate after catheter removal and role of NVB preserving are not yet clear. In this study, we sought to compare the immediate continence rate between Retzius-sparing RALP and conventional approach RALP and whether NVB preserving effect continence rate when patient underwent Retzius-sparing RALP.
Materials and Methods: This was a retrospective, single-center, single surgeon case series of 100 patients, undergoing RALP between 2014-2016. 50 patient under went conventional RALP and 50 underwent Retzius-sapring RALP. All procedure s were performed by single surgeon at single institution. Baseline patient characteristics were recorded and analyzed. Continence result and Oncology outcome was compared between two groups. Continence outcome of NVB preserving in Retzius-sapring RALP was also analyzed.
Results: No difference between two groups considering age, prostate size, pathology T stage, PSA and nerve sparing. Oncology result include surgical margin and biochemical recurrence rate at one year appear to be no difference among two groups. In immediate continence result, Retzius-sapring group showed better continence result (odds ratio 7.6176, p<0.0001) after Foley removal. But there was no difference between two groups after 6 months. Furthermore, no significant difference of immediate continence result in Retzius-sapring group whether NVB sparing was performed or not(Odds ratio 0.5921, p 0.2558).
Conclusions: Retzius-sapring RALP may provided better immediate continence result and same oncology outcome compare with conventional RALP. In Retzius-sapring RALP, NVB preserving might have no benefit in immediate continence after the operation.