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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 1 - 10 (10page)
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Robotic radical prostatectomy (RARP) is a standardized treatment for localized prostate cancer, which provides better functional outcomes and similar oncological outcomes compared to open approaches. Here, we share our experience of 12,000 RARPs by describing the outcomes of the procedure in terms of positive surgical margin (PSM), continence, and potency as well as by presenting our detailed surgical technique with recent modifications. On cancer control, the PSM rates were 5.8% and 26.1% in T2 and T3, respectively. On the premise of not compromising oncologic outcomes, a tailored approach to individual patients is essential. Even if an extracapsular extension is suspected, neurovascular bundle (NVB) tailoring can be applied using an anatomical landmark to preserve maximal nerve tissue with a negative margin. We developed a nomogram as a useful tool for deciding the degree of tailoring. For improvements of functional outcomes, we used athermal retrograde early release with a toggling technique, wherein the nerve dissection from the bottom helps with blood loss and allows for smooth NVB releasing. Additionally, we recently performed a new minimal apical dissection/lateral prostatic fascia preservation technique. As a result, our 1-week continence rate was 37% and the 6-week rate was 77.6%. In addition, the potency rates in our study were 69%, 82%, and 92% at 3 months, 6 months, and 1 year, respectively (preoperative Sexual Health Inventory for Men scores >21 & bilateral full nerve spared).
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참고문헌 (60)
참고문헌 신청
Ficarra V / 2007 / Evidence from robot-assisted laparoscopic radical prostatectomy : a systematic review / Eur Urol 51:45~55
Ficarra V / 2009 / Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies / Eur Urol 55:1037~1063
Porpiglia F / 2013 / Randomised controlled trial comparing laparoscopic and robot-assisted radical prostatectomy / Eur Urol 63:606~614
Willis DL / 2012 / Comparison of outcomes between pure laparoscopic vs robot-assisted laparoscopic radical prostatectomy : a study of comparative effectiveness based upon validated quality of life outcomes / BJU Int 109:898~905
Eastham JA / 2008 / Predicting an optimal outcome after radical prostatectomy : the trifecta nomogram / J Urol 179:2207~2210
Ficarra V / 2009 / Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies / Eur Urol 55:1037~1063
Porpiglia F / 2013 / Randomised controlled trial comparing laparoscopic and robot-assisted radical prostatectomy / Eur Urol 63:606~614
Willis DL / 2012 / Comparison of outcomes between pure laparoscopic vs robot-assisted laparoscopic radical prostatectomy : a study of comparative effectiveness based upon validated quality of life outcomes / BJU Int 109:898~905
Eastham JA / 2008 / Predicting an optimal outcome after radical prostatectomy : the trifecta nomogram / J Urol 179:2207~2210
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