Effect of Hood's technique on urinary continence after single-port robot-assisted laparoscopic radical prostatectomy
Objective To assess the effect of Hood's technique on urinary continence in patients undergoing single-port robot-assisted radical prostatectomy(spRARP).Methods The clinical data of 53 patients who underwent spRARP performed by a single surgeon in the First Affiliated Hospital of Harbin Medical University from June 2021 to October 2023 were retrospectively analyzed.There were 25 patients in the spRARP+Hood group and 28 patients in the spRARP group.There were no statistically significant differences between the spRARP+Hood group and the spRARP group in terms of patients'age[(70.28±5.98)years vs.(60.89±6.86)years old],body mass index[(24.64±2.85)kg/m2 vs.(24.59±3.17)kg/m2],prostate weight[70.00(40.69,102.25)g vs.73.50(49.13,94.50)g],total prostate specific antigen[8.62(4.56,15.26)ng/ml vs.12.68(6.99,19.24)ng/ml],Gleason score[8(7,8)vs.8(7,8)],age-adjusted Charlson comorbidity index(aCCI)[4(3,5)vs.3(3,4)],and clinical stage[T2a/T2b/T2c:6/10/9 cases vs.5/7/16 cases](P＞0.05).In the SpRARP+Hood group,the detrusor apron,tendon arch,pubic prostatic ligament,and dorsal vascular complex were completely preserved during the operation.In contrast,this was not the case for spRARP.Additionally,the incision size,bleeding volume,intraoperative blood transfusion volume,operation time,gastrointestinal function recovery time,total amount of drainage in the first three postoperative days,retention time of the drainage tube,postoperative hospitalization time,positive incision margins,recovery rate of urinary continence immediately after removal of the urinary catheter,and the recovery rate of urinary continence at 1,3,and 6 months postoperatively were compared between the two groups.Results All 53 surgeries were successfully completed.The differences in incision length[4.0(3.5,4.0)cm vs.4.0(4.0,4.0)cm],intraoperative bleeding[50(40,100)ml vs.100(50,100)ml],and intraoperative transfusion rate[4.0％(1/25)vs.17.8％(5/28)]were not statistically significant between the spRARP+Hood group and the spRARP group(P＞0.05),and the difference in operative time[205.0(167.5,240.0)min vs.242.5(185.0,300.0)min]was statistically significant(P＜0.05).The recovery time of gastrointestinal function in the spRARP+Hood group vs.the spRARP group[1.0(1.0,1.5)dvs.1.0(1.0,2.0)d],total amount of drainage in the first 3 d postoperatively[150.00(72.50,261.00)ml vs.230.00(115.00,417.50)ml],duration of drain retention[5.0(4.0,5.0)dvs.5.0(4.0,6.8)d],postoperative hospital stay[5.0(4.0,7.5)dvs.5.0(3.3,7.8)d],and margin positivity rate[4.0％(1/25)vs.3.6％(1/28)]were not statistically significant(P＞0.05).The postoperative Clavien-Dindo complication classification was grade Ⅰ in both groups.The differences between the spRARP+Hood group and the spRARP group in the rates of recovery of urinary continence immediately after the urinary catheter removal[56.0％(14/25)vs.7.1％(2/28)]and one month after surgery[76.0％(19/25)vs.28.5％(8/28)]were statistically significant(P＜0.05).The differences in the rates of recovery of urinary continence at 3 months after surgery[80.0％(20/25)vs.67.8％(19/28)],at 6 months after surgery[88.0％(22/25)vs.96.4％(27/28)],and biochemical recurrence at 6 months after surgery[4.0％(1/25)vs.3.6％(1/28)]were not statistically significant(P＞0.05).Conclusions The outcomes of spRARP+Hood in the treatment of localized prostate cancer were comparable to those of spRARP.However,spRARP+Hood has better urinary continence immediately after removal of the urinary catheter and 1 month postoperatively.
万方数据
维普
