經尿道前列腺切除術對於達文西機械手臂攝護腺根除術的影響
鍾卓興、高偉棠
行政院衛生福利部雙和醫院泌尿科
Outcomes of robot-assisted radical prostatectomy in men with previous transurethral resection of prostate
Chung Cho-Hsing, Kao Wei-Tang
Departmentof Urology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
Purpose:
To critically analyze and compare surgical, oncological and functional outcomes of robot-assisted radical prostatectomy (RARP) in patients with and without previous transurethral resection of prostate (TURP).
Materials and methods:
This is a retrospective study by chart review. The study comprised 76 cases of RARP for clinically localized prostate cancer, including 19 cases that had undergone previous TURP (Group A). Surgical, oncological and functional outcomes of Group A were compared with 57 cases without previous TURP (Group B).
Results:
Post TURP patients were found to have significantly greater blood loss (279 vs 271 mL) compared to the non-TURP group. Surgical time (324 vs 322 min) was also higher. While margin positivity rates and biochemical recurrence rates were not higher. Incontinence rates were higher within 12 months follow-up.
Conclusion:
RARP is feasible but challenging after TURP. It entails a longer operating time, greater operative difficulty and compromised continence outcomes. These cases should be handled by an experienced robotic surgeon with the appropriate expertise.