[Half-day case robotic radical prostatectomy. Surgery of the future? A case report].

Autor: Leclers F; Service de chirurgie urologique, clinique Alpes-Belledonne, 31, rue Alexandre-Dumas, 38000 Grenoble, France. Electronic address: francoisleclers33@hotmail.com., Dutheil V; Département d'anesthésie-réanimation, clinique Alpes-Belledonne, 31, rue Alexandre-Dumas, 38000 Grenoble, France., Poupot D; Département d'anesthésie-réanimation, clinique Alpes-Belledonne, 31, rue Alexandre-Dumas, 38000 Grenoble, France., Moalic R; Service de chirurgie urologique, clinique Alpes-Belledonne, 31, rue Alexandre-Dumas, 38000 Grenoble, France., Gosseine PN; Service de chirurgie urologique, clinique Alpes-Belledonne, 31, rue Alexandre-Dumas, 38000 Grenoble, France., Cormier L; CHU de Dijon, 1, boulevard Jeanne-d'Arc, 21000 Dijon, France; Comité de cancérologie de l'AFU, 75000 Paris, France., Bierman D; Département d'anesthésie-réanimation, clinique Alpes-Belledonne, 31, rue Alexandre-Dumas, 38000 Grenoble, France.
Jazyk: francouzština
Zdroj: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie [Prog Urol] 2016 Jan; Vol. 26 (1), pp. 10-3. Date of Electronic Publication: 2015 Nov 14.
DOI: 10.1016/j.purol.2015.10.004
Abstrakt: Introduction: Robotics and ambulatory are modern applications of surgery. This case study proves the feasibility of robot-assisted radical prostatectomy as an outpatient procedure.
Method: This report highlights the first, half-day, robotic prostatectomy performed on a 57-year-old man with localized prostate cancer. This operation was proposed to the subject because of his excellent physical condition and favorable environmental factors. He chose to undergo the surgery voluntarily. He underwent a nerve sparing radical prostatectomy. Target-controlled infusion propofol was used in perioperative sedation and analgesia. Postoperative evaluation criteria was made with the Visual Analog Scale of Pain Intensity (VASPI), Chung score and a patient satisfaction survey.
Results: No perioperative or postoperative complications were reported. Blood loss was low (75 mL). The patient stayed less than 12 hours in the ambulatory unit thanks to a rapid recovery. The patient returned home after reporting a Chung score of 10. No hospital readmission was necessary. Functional results were: a bowel movement on day 1, back to work on day 2, normal urinary continence on day 8, a correct erectile function on day 9. Oncological results revealed negative surgical margins for cancer and PSA postoperative<0.03 ng/mL.
Conclusion: Ambulatory robotic radical prostatectomies can be performed on voluntarily-selected patients without affecting the high quality of urological surgery outcomes.
(Copyright © 2015 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE