Cystopexy following anterior-approach robot-assisted radical prostatectomy enhances early continence recovery.

IF 2.2 3区 医学 Q2 SURGERY
Yu-Hsiang Huang, Jonathan Y J Chen, See-Tong Pang, Kai-Jie Yu, Hung-Cheng Kan, I-Hung Shao, Liang-Kang Huang, Chun-Te Wu, Po-Hung Lin
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Abstract

To evaluate the effect of cystopexy on continence recovery after anterior-approach transperitoneal robot-assisted radical prostatectomy (RaRP). We retrospectively analyzed continence recovery of patients with prostate cancer receiving RaRP in a transperitoneal anterior-approach manner with or without cystopexy. Continence recovery is defined as complete intact continence without safety pad utility. Demographic data, preoperative cancer staging, intraoperative surgical techniques such as neurovascular bundle (NVB) preservation, bladder neck sparing (BNS), cystopexy and postoperative cancer stage, surgical margin status were analyzed via multivariable and univariable regression analysis to evaluate contributing factors associated with continence recovery. We included one hundred and sixty-one consecutive RaRP performed by a single surgeon from 2011 to 2019 without cystopexy and another forty-one consecutive RaRP performed by another single surgeon with cystopexy from 2019 to 2023. Compared to patients without cystopexy, patients receiving cystopexy after anterior-approach RaRP have significant early continence recovery rate at 1-week (p < 0.0001) and 4-weeks (p = 0.0391). In addition, multivariable regression analysis revealed that BNS contributed to better continence recovery at 4 weeks (p = 0.0094). Patients receiving RaRP without NVB preservation had worse continence recovery at 12 weeks (p = 0.0015) and 24 weeks (p = 0.0098). Cystopexy after anterior -approach RaRP may enhance early recovery of continence at 1 week and 4 weeks. The simple technique may be adapted for a better functional outcome of continence.

前路机器人辅助根治性前列腺切除术后膀胱切除术可提高早期失禁恢复。
目的探讨膀胱切除术对前路经腹膜机器人辅助根治性前列腺切除术(RaRP)术后尿失禁恢复的影响。我们回顾性分析了前列腺癌患者在经腹膜前入路接受RaRP治疗并伴有或不伴有膀胱封锁术的失禁恢复情况。自制恢复被定义为完全完整的自制,没有安全垫的效用。通过多变量和单变量回归分析,分析人口统计学资料、术前肿瘤分期、术中手术技术如神经血管束(NVB)保存、膀胱颈部保留(BNS)、膀胱填塞术及术后肿瘤分期、手术切缘状况,以评价与失禁恢复相关的因素。我们纳入了2011年至2019年由一名外科医生连续进行的161例未进行膀胱截截术的RaRP,以及2019年至2023年由另一名外科医生连续进行的41例膀胱截截术。与未行膀胱截留术的患者相比,经前路RaRP术后行膀胱截留术的患者在1周早期尿失禁恢复率显著(p
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来源期刊
CiteScore
4.20
自引率
8.70%
发文量
145
期刊介绍: The aim of the Journal of Robotic Surgery is to become the leading worldwide journal for publication of articles related to robotic surgery, encompassing surgical simulation and integrated imaging techniques. The journal provides a centralized, focused resource for physicians wishing to publish their experience or those wishing to avail themselves of the most up-to-date findings.The journal reports on advance in a wide range of surgical specialties including adult and pediatric urology, general surgery, cardiac surgery, gynecology, ENT, orthopedics and neurosurgery.The use of robotics in surgery is broad-based and will undoubtedly expand over the next decade as new technical innovations and techniques increase the applicability of its use. The journal intends to capture this trend as it develops.
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