Estrategias para mejorar los resultados funcionales asociados a neuropreservación en prostatectomía radical laparoscópica asistida por robot

Q4 Medicine

Revista mexicana de urologia Pub Date : 2016-03-01 DOI:10.1016/j.uromx.2015.12.001

V. Cornejo-Dávila , N. Kella , M.A. Palmeros-Rodríguez , J.G. Morales-Montor , C. Pacheco-Gahbler

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引用次数: 1

Abstract

Background

Preservation of neurovascular bundles is one of the most important aspects regarding functional outcomes during radical prostatectomy. The use of robotic-assisted laparoscopy has helped to improve preservation. Other strategies to improve nerve sparing have recently been used, including the use of intraoperative nerve monitoring, intrafascial and interfascial dissection, and the use of patches to accelerate nerve function recovery.

The aim of our report was to show new strategies for nerve sparing in robotic-assisted laparoscopic radical prostatectomy (RALRP), exemplified by a clinical case.

Clinical case

A 42-year-old African-American man with intermediate-risk prostate cancer and good preoperative erectile function underwent RALRP, with an emphasis on careful nerve sparing.

Conclusions

Functional results are greatly relevant when performing RALRP, given that they are expected to be better with this technology. Despite the magnified vision achieved during robotic-assisted surgery, nerve fibers of the neurovascular bundles can be missed. Therefore, adhering to careful intrafascial dissection is essential, aided by the use of nerve monitoring and amniotic membrane patches, for improving outcome with respect to continence and erectile function in these patients.

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背景:神经血管束的保存是根治性前列腺切除术中功能预后最重要的方面之一。机器人辅助腹腔镜的使用有助于改善保存。其他改善神经保留的策略最近被采用，包括术中神经监测，筋膜内和筋膜间剥离，以及使用贴片加速神经功能恢复。我们报告的目的是通过一个临床病例来展示机器人辅助腹腔镜根治性前列腺切除术(RALRP)中神经保留的新策略。临床病例:一名42岁的非裔美国男性，患有中度前列腺癌，术前勃起功能良好，接受RALRP手术，重点是小心保留神经。结论:在进行RALRP时，功能结果是非常重要的，因为使用该技术可以获得更好的结果。尽管在机器人辅助手术中获得了放大的视觉，但神经血管束的神经纤维可能会丢失。因此，在神经监测和羊膜贴片的辅助下，坚持仔细的筋膜内剥离是必不可少的，以改善这些患者的尿失禁和勃起功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista mexicana de urologia Medicine-Urology

CiteScore

0.20

自引率

0.00%

发文量

期刊介绍： Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.