Laparoskopska radikalna prostatektomija: serija slučajeva jednog centra
| Autor: | Penezić, Luka, Kuliš, Tomislav, Hudolin, Tvrtko, Zekulić, Toni, Saić, Hrvoje, Kaštelan, Željko |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Acta clinica Croatica Volume 61. Issue Supplement 3 |
| ISSN: | 1333-9451 0353-9466 |
| Popis: | Laparoscopic radical prostatectomy (LRP) is traditionally characterized as a technically difficult procedure with a long learning curve but it is successfully performed worldwide. The aim of this paper was to assess the initial learning curve and clinical outcomes for LRP in our center. We performed a retrospective study including 63 LRP cases, in the course of 22 months, performed by 2 urologists, with no previous LRP experience. All patients were previously assessed by a multidisciplinary team and were selected on the basis of low and intermediate risk disease attributes according to the classification of prostate cancer risk groups of the European Association of Urology. The main outcomes of follow-up are procedure duration, estimated blood loss, complications, positive surgical margins, biochemical relapse and urinary continence. The median follow-up was 19.6 months. The median procedure duration was 196.8 minutes and median blood loss 257.1 mL. Significant decrease in both outcomes was observed when comparing first and last cases in the series. There were 5 (7.9%) Clavien Dindo grade II complications. Undetectable prostate specific antigen (PSA) was observed in 59 (93.6%) patients, and fifty-five patients (87.3%) were continent. Following a methodical learning approach, LRP can be safely mastered with favorable outcomes. Laparoskopska radikalna prostatektomija (LRP) tradicionalno se smatra tehnički zahtjevnom operacijom s dugom krivuljom učenja, ali se uspješno primjenjuje u cijelome svijetu. Cilj rada je prikazati krivulju učenja i ishode liječenja za LRP u našem centru. Proveli smo retrospektivnu studiju koja je uključila 63 pacijenta tijekom 22 mjeseca. Sve zahvate izvela su 2 specijalista urologa bez iskustva u LRP. Uključene pacijente prethodno je procijenio multidisciplinarni tim te su imali karakteristike nisko i srednje rizičnog bolesti prema klasifikaciji karcinoma prostate Europskog urološkog udruženja. Glavni ishodi praćenja bili su trajanje operacije, procijenjen gubitak krvi, učestalost komplikacija, prisutnost pozitivnog kirurškog ruba, biokemijski povrat bolesti i kontinencija mokraće. Medijan praćenja bio je 19.6 mjeseci. Medijani trajanja operacije i procijenjenog gubitka krvi bili su 196.8 minuta i 257.1 mL. Značajno smanjenje oba parametra zabilježeno je uspoređujući zadnje s prvim slučajevima u seriji. Zabilježeno je 5 (7.9%) Clavien Dindo stupanj II komplikacija. Nemjerljiv post-operacijski prostata specifični antigen (PSA) imalo je 59 (93.6%) pacijenata, a pedeset i pet pacijenata (87.3%) bilo je kontinentno. Prateći metodičan sustav učenja, moguće je na siguran način savladati LRP u zadovoljavajuće ishode liječenja. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|