Application of super-veil technique in 3D laparoscopic extraperitoneal radical prostatectomy for the treatment of localized prostate cancer
Objective To explore the feasibility of performing extraperitoneal 3D laparoscopic radi-cal prostatectomy with the super-Veil technique for treating localized prostate cancer in community hospi-tals.Methods We retrospectively analyzed the clinical data of 88 patients with clinically localized pros-tate cancer who underwent 3D laparoscopic radical prostatectomy at Ningbo Urological and Nephrology Hos-pital from January 2020 to December 2022.Patients were divided into the super-Veil group and the control group based on surgical technique differences.Inclusion and exclusion criteria were the same for both groups,with normal preoperative urination,regular lifestyle,and preoperative clinical staging of cT1-2 N0M0.The super-Veil group underwent surgery using the previously reported super-Veil technique that pre-serves and reconstructs the periprostatic anatomical structures.The control group underwent other surgical techniques.Operative time,intraoperative blood loss,postoperative pathological findings,postoperative prostate specific antigen(PSA)levels,urinary continence recovery,and sexual function recovery time were recorded and compared between groups.Quantitative data were analyzed using t-tests and count data using chi-square tests.Results No patients required secondary surgery,conversion to open surgery,intraopera-tive change of surgical method,or unplanned re-admission postoperatively.No significant differences were found in baseline clinical characteristics,postoperative pathological findings,or positive surgical margin rates between the two groups.The super-Veil group had longer operative time[(177.3±56.3)min vs.(159.9±44.4)min,t=1.621,P＞0.05]and greater estimated blood loss[(130.5±69.7)ml vs.(117.9±65.4)ml,t=0.878,P＞0.05]than controls,but the differences were not statistically signifi-cant.Regarding urinary continence recovery,the super-Veil group had significantly higher rates immediate-ly,at 1 month,and 3 months postoperatively(33.3％,71.8％,87.2％vs.14.3％,32.7％,57.1％,X2=6.075,13.308,9.476,P＜0.05).For sexual function recovery,a higher proportion of the super-Veil group had IIEF scores ≥12 at 1 and 12 months postoperatively(30.8％and 64.1％vs.10.2％and 42.9％for controls,x2==5.893,3.929,P＜0.05).Conclusion The super-Veil technique for 3D laparoscopic radical prostatectomy is feasible in community hospitals and may improve patients'quality of life while reducing the need for advanced medical resources.
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