Retzius Koruyucu Robot Yardımlı Radikal Prostatektomi ile Konvansiyonel Robot Yardımlı Radikal Prostatektominin Cerrahi Sınır Pozitifliği Açısından Karşılaştırılması

Yıl 2024, Cilt: 16 Sayı: 3, 75 - 83, 29.09.2024

Ali Kaan Yıldız , Arif Bedirhan Bayraktar , Demirhan Örsan Demir , Turgay Kaçan , Yusuf Gökkurt , Buğra Bilge Keseroğlu , Tolga Karakan

https://doi.org/10.54233/endourolbull-1485755

Öz

Amaç: Prostat kanserinin cerrahi tedavisinde Retzius koruyucu robot yardımlı radikal prostatektomi (RK–RYRP) ile konvansiyonel robot yardımlı radikal prostatektomi (K-RYRP)’yi cerrahi sınır pozitifliği açısından karşılaştırmayı amaçladık.
Materyal ve Metod: Ocak 2022 – Eylül 2023 tarihleri arasında lokalize prostat kanseri tanısı konmuş, RK-RYRP ve K-RYRP yapılan 57 hastanın erken dönem onkolojik sonuçları (ISUP derecesi, T evresi, mesane boynu invazyonu, ektrakapsüler yayılım, seminal vezikül invazyonu, lenf nodu invazyonu ve cerrahi sınır pozitifliği) incelendi.
Bulgular: RK-RYRP grubundaki hastalar, K-RYRP grubundaki hastalar ile karşılaştırıldığında yaş, VKİ, preoperatif PSA, prostat hacmi ve preoperatif ISUP dereceleri açısından anlamlı bir farklılık izlenmedi (hepsi p>0.05). Ortalama operasyon süresi açısından her iki grup arasında fark görülmedi (p=0,06).
Cerrahi sınır pozitifliği; RK-RYRP grubundaki hastaların %34,6’sında, K-RYRP grubundaki hastaların %25,8’inde saptandı ve her iki grupta anlamlı farklılık saptanmadı (p=0,4). Cerrahi spesmenin ISUP dereceleri ve T evreleri benzerdi (hepsi p>0,05). Lenf nodu invazyonu, ekstrakapsüler yayılım, seminal vezikül invazyonu ve mesane boynu invazyonu açısından da her iki grupta istatistiksel olarak anlamlı fark görülmedi (hepsi p>0,05).
Sonuç: Retzius koruyucu robot yardımlı laparoskopik radikal prostatektomi, prostat kanseri cerrahisi için erken onkolojik sonuçlar açısından konvansiyonel yöntemle karşılaştırıldığında uygulanabilir bir yöntemdir. Ancak, uzun dönem onkolojik sonuçlar (özellikle biyokimyasal rekürrens açısından) için daha fazla veriye ihtiyaç vardır.

Anahtar Kelimeler

prostatektomi, retzius koruyucu, robotik, cerrahi, konvansiyonel

Comparison of Retzius Sparing Robot-Assisted Radical Prostatectomy and Conventional Robot-Assisted Radical Prostatectomy in Terms of Surgical Margin Positivity

Öz

Objective: To compare Retzius-sparing robot assisted radical prostatectomy (RS-RARP) and conventional robot assisted radical prostatectomy (C-RARP) in the surgical treatment of prostate cancer in terms of surgical margin positivity.
Methods: Early oncological results (ISUP grade, T stage, bladder neck invasion, extracapsular extension, seminal vesicle invasion, lymph node invasion and positive surgical margin) oh 57 patients who were diagnosed with localised prostate cancer and underwent RS-RARP and C-RARP between January 2022 and September 2023 were analysed.
Results: There was no significant difference in age, BMI, preoperative PSA, prostate volume and preoperative ISUP grades when the RS-RARP group was compared with the C-RARP group (p>0,05, all). There was no difference between the two groups in terms of mean operation time (p=0,06).
Surgical margin positivity was found in 34.6% of the patients in the RS-RARP group and in 25.8% of the patients in the C-RARP group and no significant difference was found in both groups (p = 0,4). ISUP grades and T stages of the surgical specimen were similar (p>0,05, all). There was no statistically significant difference in lymph node invasion, extracapsular extention, seminal vesicle invasion and bladder neck invasion (p>0,05, all).
Conclusion: Retzius sparing robot assisted laparoscopic radical prostatectomy is a feasible method for prostate cancer surgery compared to the conventional method in terms of early oncological results. However, more data are needed for long-term oncological outcomes (especially in terms of biochemical recurrence).

Anahtar Kelimeler

prostatectomy, retzius sparing, robotic, surgery, conventional

Kaynakça

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