Effects of robot assisted and pure laparoscopic radical prostatectomy on urinary control function in elderly patients

doi:10.3877/cma.j.issn.1674-3253.2023.02.015

Abstract

Abstract:

Objective

To investigate the effects of robot assisted and pure laparoscopic radical prostatectomy on urinary control function in elderly patients.

Methods

The clinical data of elderly patients (≥65 years old) underwent robot assisted or pure laparoscopic radical prostatectomy from January 2017 to April 2020 in the 900th Hospital of PLA were retrospectively analyzed. The operation time, intraoperative blood loss, intraoperative complications, conversion to open surgery, postoperative hospital stay, postoperative complications, early and long-term urinary control recovery of robot assisted laparoscopic (robot group, n=37) and laparoscopic radical prostatectomy (laparoscopic group, n=62) were compared.

Results

The intraoperative blood loss in the robot group [(141±37) ml] was significantly lower than that in the laparoscopic group [(160±41) ml], the postoperative complications (5.4% vs 21.0%) and postoperative hospital stay [(4.5±1.2) d vs (5.1±1.4 d)] were significantly lower than those in the laparoscopic group. The recovery of early urinary control (43.2% vs 24.2%) after operations (1 month) in the robot group was significantly better than that in the laparoscopic group, and the use of urinary pads in patients with incomplete recovery of urinary control was significantly less than that in the laparoscopic group(all P<0.05). There was no significant difference in operation time, intraoperative complications, conversion to laparotomy, long-term urinary control recovery and urine pad usage in patients with incomplete recovery of urinary control after operations (3, 6 and 12 months) (all P>0.05).

Conclusions

Robot assisted laparoscopic radical prostatectomy for elderly patients with small trauma, and can promote the early recovery of urinary control function.

Key words: Robot, Laparoscopy, Radical prostatectomy, Elderly, Urinary control function

Rong Liu, Mingfang Weng, Chunyu Guo, Renhui Qiu, Xiao Fang, Limin He, Zhen Deng. Effects of robot assisted and pure laparoscopic radical prostatectomy on urinary control function in elderly patients[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(02): 169-172.

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References 15

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组别	例数	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	ASA分级(例)			前列腺体积[ml，(±s)]	国际前列腺症状评分[分，(±s)]
组别	例数	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	Ⅰ	Ⅱ	Ⅲ	前列腺体积[ml，(±s)]	国际前列腺症状评分[分，(±s)]
机器人组	37	70.5±2.8	23.1±1.7	12	20	5	36±10	16±5
腹腔镜组	62	69.7±2.5	23.4±1.9	13	41	8	36±12	15±4
统计值		t=1.472	t=0.790	χ²=1.761			t=0.251	t=0.419
P值		0.144	0.432	0.415			0.802	0.676
组别	术前PSA[ng/ml，(±s)]	病理分期(例)		ASA分级(例)				术后辅助治疗(例)
组别	术前PSA[ng/ml，(±s)]	pT₁	pT₂	极低危	低危	中危	高危	放射治疗	内分泌治疗
机器人组	8.6±2.5	12	25	2	23	9	3	2	3
腹腔镜组	9.1±2.7	19	43	5	39	14	4	4	7
统计值	t=0.916	χ²=0.034		χ²=0.354				χ²=0.324
P值	0.362	0.853		0.950				0.851

组别	例数	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	ASA分级(例)			前列腺体积[ml，(±s)]	国际前列腺症状评分[分，(±s)]
组别	例数	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	Ⅰ	Ⅱ	Ⅲ	前列腺体积[ml，(±s)]	国际前列腺症状评分[分，(±s)]
机器人组	37	70.5±2.8	23.1±1.7	12	20	5	36±10	16±5
腹腔镜组	62	69.7±2.5	23.4±1.9	13	41	8	36±12	15±4
统计值		t=1.472	t=0.790	χ²=1.761			t=0.251	t=0.419
P值		0.144	0.432	0.415			0.802	0.676
组别	术前PSA[ng/ml，(±s)]	病理分期(例)		ASA分级(例)				术后辅助治疗(例)
组别	术前PSA[ng/ml，(±s)]	pT₁	pT₂	极低危	低危	中危	高危	放射治疗	内分泌治疗
机器人组	8.6±2.5	12	25	2	23	9	3	2	3
腹腔镜组	9.1±2.7	19	43	5	39	14	4	4	7
统计值	t=0.916	χ²=0.034		χ²=0.354				χ²=0.324
P值	0.362	0.853		0.950				0.851

组别	例数	手术时间[min，(±s)]	术中失血量[ml，(±s)]	术中并发症（例）	中转开腹（例）	术后住院时间[d，(±s)]	术后并发症[例(%)]
机器人组	37	121±26	141±37	0	0	4.5±1.2	2（5.4）
腹腔镜组	62	119±23	160±41	1	1	5.1±1.4	13（21.0）
统计值		t=0.563	t=2.262	-^a	-^a	t=2.173	χ²=4.365
P值		0.575	0.026	1.000	1.000	0.032	0.037

组别	例数	手术时间[min，(±s)]	术中失血量[ml，(±s)]	术中并发症（例）	中转开腹（例）	术后住院时间[d，(±s)]	术后并发症[例(%)]
机器人组	37	121±26	141±37	0	0	4.5±1.2	2（5.4）
腹腔镜组	62	119±23	160±41	1	1	5.1±1.4	13（21.0）
统计值		t=0.563	t=2.262	-^a	-^a	t=2.173	χ²=4.365
P值		0.575	0.026	1.000	1.000	0.032	0.037

	例数	术后1个月	术后3个月	术后6个月	术后12个月
机器人组	37	16(43.2)	27(73.0)	31(83.8)	34(91.9)
腹腔镜组	62	15(24.2)	36(58.1)	50(80.6)	56(90.3)
χ²值		3.910	2.226	0.153	0.000
P值		0.048	0.136	0.695	1.000

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