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Actas Urol Esp ; 39(2): 70-7, 2015 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24856651

RESUMO

BACKGROUND: We report the operative details and short term oncologic and functional outcome of the first 334 Robotic-assisted radical prostatectomy experiences for organ confined prostate cancer METHODS: From August 2009 to December 2012, details of 334 consecutive patients were retrospectively analyzed. The analyzed parameters included: preoperative, per-operative characteristics, postoperative minor and major complications, positive surgical margin continence, potency, and biochemical progression at the follow-up period. RESULTS: The classical extrafascial, interfascial, intrafascial and fascia sparing radical prostatectomy were performed in 31, 41, 200, and 62 cases, respectively. The mean operation time was 213.8±90.1minutes, and the mean estimated blood loss was 116.1±58.9cc during operation. A nerve-sparing procedure was performed bilaterally in 198 (59.3%) cases and unilaterally in 126 (37.7%) cases. The catheter was removed on postoperative day 9, 1±1.9. Surgical margin was positive in 36 (10.7%) patients. The overall, pT2, pT3a and pT3b PSM rates were 8 (2.4%), 12 (3.6%), 16 (4.8%) respectively and PSM and BCR rates were not statistically different among four approach (P>.05). At the follow-up period, the continence rates were 74.4%, 80.4%, 80.5%, and 96.7% (P<.001), and previously potent patients' potency rates were 64.3%, 66.6%, 68.1%, and 74.5% (P>.05), in classic extrafascial, interfascial, intrafascial, and fascia sparing intrafascial prostatectomy, respectively. CONCLUSION: RARP is a safe and feasible technique in treatment of localized prostate cancer. Fascia sparing approach has better continence rate. This results need to be supported by new prospective, randomized studies.


Assuntos
Adenocarcinoma/cirurgia , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Robótica/métodos , Idoso , Perda Sanguínea Cirúrgica , Disfunção Erétil/etiologia , Disfunção Erétil/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Tratamentos com Preservação do Órgão , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Prostatectomia/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento , Incontinência Urinária/etiologia , Incontinência Urinária/prevenção & controle
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