经腹膜外三孔法机器人辅助前列腺癌根治术的初步经验

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Preliminary experience with robot，assisted radical prostatectomy by extraperitoneal three，hole method

TAN Yunfei，SONG Yu，XIE Huyang，GUAN Yangbo，CAI Bo，MA Limin

（Department of Urology，Affiliated Hospital of Nantong University，Nantong 226001，China）

ABSTRACT：ObjectiveTo introduce a surgical technique modified by our center，the establishment of a robot，assisted radical prostatectomy （RARP） channel with extraperitoneal three，port method，and discuss its methods，skills，safety and efficacy.MethodsClinical data of 21 patients with early and intermediate prostate cancer treated with this surgery during Aug.2022 and Jun.2023 were retrospectively analyzed.Surgical time，intraoperative bleeding volume，postoperative complications，drainage tube retention time，postoperative hospital stay，and follow，up results were observed.ResultsAll 21 cases of surgery were successfully completed by the same surgeon，without peritoneal rupture or addition of auxiliary holes.The time to establish the extraperitoneal gap and install robotic arm was 20.2 （16.0-28.0） min，the operation time was 107.0（600-161.0） min，the amount of intraoperative bleeding was 52.8 （31.0-121.0） mL.All patents resumed eating and drinking the next day after operation.The drainage tube indwelling time was 3.9 （2.0-6.0） d，and the postoperative hospital stay was 4.9 （3.0-7.0） d.No serious complications occurred.The urinary catheter was removed 10 days after operation.One month after operation，20 patients （95.2%） achieved satisfactory urinary control.The postoperative pathology was prostate adenocarcinoma in all cases，with negative margins，and the prognostic grouping of ISUP was 2 cases in group 1，6 cases in group 2，10 cases in group 3，2 cases in group 4，and 1 case in group 5.ConclusionRARP by extraperitoneal three，hole method is safe and feasible，with exact establishment of extraperitoneal space，few collisions between instruments，low surgical costs，fast postoperative intestinal recovery，aesthetic incision，and satisfactory recovery of urinary control.

KEY WORDS：prostate cancer；extraperitoneal approach；robot，assisted radical prostatectomy；trocar placement；three，hole method;establishiment of operation access

摘要：目的介绍一种经本中心改良的手术技术——经腹膜外三孔法机器人辅助前列腺癌根治术（RARP）通道建立，探讨其操作方法、安全性及效果。（剩余6761字）