Abstract:

Objective

To review the safety and efficacy of anterior approach robot-assisted radical prostatectomy （AP-RARP） in the treatment of prostate cancer through a retrospective analysis.

Methods

Clinical data of 82 patients with cT1c-T3a stage prostate cancer who underwent AP-RARP at Nanjing Drum Tower Hospital from December 2019 to December 2021 were collected. The surgical procedure began by initially separating the seminal vesicles， vas deferens， and the posterior wall of the prostate through a posterior approach. Subsequently， the procedure was then switched to an anterior approach to complete the remaining surgical steps. Perioperative and early postoperative complications were recorded， along with postoperative urinary continence rate， erectile function， and positive surgical margin rate.

Results

All 82 surgeries were successfully completed. The average operation time was（105±13） minutes， with an average intraoperative blood loss of （139±62） ml. No blood transfusion was required. Postoperative complications included one case of urinary fistula and two cases of infection.The positive surgical margin rate was 7.0% （4/57） for patients with T2 stage cancer and 28.0% （7/25） for patients with T3a stage cancer. The recovery rates for urinary continence at catheter removal， 1 month，3 months， and 6 months postoperatively were 17.1% （14/82）， 46.3% （38/82）， 84.1% （69/82）， and 98.8%（81/82）， respectively.

Conclusion

AP-RARP combines the advantages of anterior approach RARP and Retzius-sparing RARP， making it one of the viable surgical options for the treatment of prostate cancer.

Key words: Prostate cancer, Robotic Surgical, Laparoscope, Prostatectomy