로봇 근치적 전립선적출술에서 복막 외 접근법과 복막 내 접근법의 수술 결과 비교: 단일 술자의 경험
Comparison of Extraperitoneal and Transperitoneal Robot-Assisted Radical Prostatectomy in Prostate Cancer: A Single Surgeon’s Experience
이용승, 함원식, 김원태, 주희정, 이진선, 최영득,
소속 상세정보
이용승 ( Lee Yong-Seung )
연세대학교 의과대학 비뇨기과학교실
함원식 ( Ham Won-Sik )
연세대학교 의과대학 비뇨기과학교실
김원태 ( Kim Won-Tae )
연세대학교 의과대학 비뇨기과학교실
주희정 ( Ju Hee-Jeong )
연세대학교 의과대학 비뇨기과학교실
이진선 ( Lee Jin-Sun )
연세대학교 의과대학 비뇨기과학교실
최영득 ( Choi Young-Deuk )
연세대학교 의과대학 비뇨기과학교실
KMID : 0358320090500030251
Abstract
Purpose: To evaluate the feasibility and safety of the extraperitoneal robotic radical prostatectomy (ERP), we compared the results of transperitoneal robotic radical prostatectomy (TRP) with those of ERP performed by a single surgeon.
Materials and Methods: All operation was performed by a single surgeon, who had the experience of more than 150 transperitoneal cases. Recently, 30 cases were performed through transperitoneal approach, and then extraperitoneal approach was applied to next 30 cases. We compared the clinicopathologic parameters and perioperative outcomes between two groups.
Results: There were no significant differences in mean age, body mass index (BMI), preoperative prostate-specific antigen (PSA) level, prostatectomy Gleason scores and pathologic T stage between two groups, whereas positive surgical margin rate was significantly lower in ERP. There was no significant difference in total operation time, whereas console time, and vesicourethral anastomosis time significantly decreased in ERP. There were no significant differences in postoperative normal diet start day, the duration of hospital stay and bladder catheterization. There were no significant differences in the amount of estimated blood loss and the number of resected lymph nodes. In both groups, there were no inadvertent organ injury during trocar placement and conversion to open surgery, whereas 1 case of lymphocele in ERP was recovered with conservative care.
Conclusions: ERP showed similar perioperative outcomes compared to TRP. Considering the potential risk of bowel injury in TRP and reduced peritoneal irritation in ERP, ERP may be alternative in robotic radical prostatectomy.
키워드
Prostatic neoplasms;Prostatectomy;Laparoscopy;Robotics
원문 및 링크아웃 정보
등재저널 정보