達文西機械手臂輔助攝護腺切除和高聚能超音波海福刀治療攝護腺癌的比較：單一醫學中心的經驗
張殷綸1、柳易揚1、羅浩倫1、陳建旭1、李偉嘉1、王弘仁1、康智雄1、鄭元佐1、陳彥達1、李維菁1、莊燿吉1、江博暉1
1高雄長庚醫院泌尿科
Comparisons of robot assisted radical prostatectomy and high intensity focused ultrasound for the treatment of prostate cancer: single center experience
Yin-Lun Chang¹, Yi-Yang Liu¹, Hao-Lun Luo¹, Chien-Hsu Chen¹, Wei-Chia Lee¹, Hung-Jen Wang¹, Chih-Hsiung Kang¹, Yuan-Tso Cheng¹, Yen-Ta Chen¹, Wei-Ching Lee¹, Yao-Chi Chuang¹, Po-Hui Chiang¹
¹ M.D., Department of Urology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Purpose: To conduct a retrospective, single institutional comparison for robotic-assisted radical prostatectomy (RARP) and high-intensity focused ultrasound (HIFU) in localized prostate cancer with respects to oncological and functional outcomes.
Materials and Methods: We reviewed 51 and 123 patients of RARP and HIFU for localized prostate cancer from April 2015 to June 2018. Oncological outcomes, perioperative parameters and functional outcomes including voiding and sexual function were compared.
Results: During near 2 years follow-up, oncological outcomes including PSA biochemical recurrence, salvage treatment, metastasis and mortality were similar between RARP and HIFU. In terms of perioperative parameters, the patients of HIFU experienced less operative time, blood loss, blood transfusion rate, catheterization time and hospital stay but higher epidiymitis rate. Moreover, HIFU provides lower urinary incontinence and de novo erectile dysfunction rate but higher urethral stricture rate.
Conclusions: In consideration of pentafecta, HIFU showed non-inferior oncological and functional outcomes to RARP. Therefore, we may choose HIFU for not only in experimental or alternative choice but also standard treatment of localized prostate cancer.