探讨机器人腹腔镜后入路完全筋膜内根治性前列腺切除术治疗局限性早期前列腺癌（PCa）的技术要领，并评估其肿瘤学和功能结果。

15例T_1-2bN₀M₀的PCa患者行机器人腹腔镜后入路完全筋膜内根治性前列腺切除术，术前行国际勃起功能指数（IIEF）-5评分。患者全麻后取平卧头低脚高位，连接机器人系统，显露道格拉斯窝，游离双侧输精管和精囊腺；紧贴前列腺后方、侧方和前方依次钝性推开狄氏筋膜前层、离断侧韧带和脏层盆筋膜；显露并离断尿道；双针连续吻合膀胱颈后尿道。记录围手术期资料和功能结果数据。所有患者术后定期随访PSA检测、日常尿垫和IIEF-5评分。

15例患者成功完成手术，中位手术时间86（65~116）min，术中失血量20（10~60）ml，围手术期无严重并发症发生。术后病理均<pT_2c，Gleason评分<8，无切缘阳性病例，术后随访均无生化复发。导尿管中位停留时间为7（6~8）d，13例患者在拔除导尿管后即刻控尿（0片/天），2例患者拔除导尿管后出现轻度失禁（2~3片/d），2周内全部恢复控尿。9例患者在术后6个月内恢复勃起功能，IIEF-5评分均>18。

机器人腹腔镜后入路完全筋膜内根治性前列腺切除术治疗中低风险局限性早期PCa患者安全有效，近期随访控瘤、控尿和勃起功能恢复效果满意。

To explore the technical essentials of robot-assisted radical prostatectomy via posterior and completely intrafascial for organ-confined prostate cancer, and to evaluate the oncological and functional outcomes.

Fifteen prostate cancer patients with T_1-2bN₀M₀ were scheduled for robot-assisted radical prostatectomy via posterior and completely intrafascial approach, and their international index of erectile function (IIEF) were performed before operation. All patient was placed in a supine position and the robotic system was established. Firstly, expose the Douglas fossa, free bilateral vas deferens and seminal vesicles, blunt dissection of the Denonvillier fascia, severed lateral ligament and visceral pelvic fascia, then exposed and disconnected urethra, continuous suture bladder neck urethra. Perioperative complications and functional outcome data were recorded. All patients were regularly followed up for tPSA testing, daily urine pads and IIEF-5 scores.

All of the 15 patients were successfully completed the operations. The median (range) operation time was 86(65-116) min, and estimated blood loss was 20 (10-60) ml, and no serious complications occurred. Postoperative pathology was <pT_2c, Gleason score <8, no cases of positive surgical margins, and no biochemical recurrence (BCR) in postoperative follow-up. Catheter were removed after a median (range) time of 7(6-8) d, 13 patients were immediately continent (0 pads/d), and two patients had mild incontinence (2-3 pads/d). All patients were observed as continent within next two weeks. Nine patients achieved a satisfactory erection at 6 months postoperatively, with an IIEF-5 score >18.

Robot-assisted radical prostatectomy via posterior and completely intrafascial approach is technically feasible for patients with low-risk localized prostate cancer and demonstrates promising functional outcomes regarding continence and potency.