Sakarya Üniversitesi’nde Robot Yardımlı Laparoskopik Radikal Prostatektomi: Başlangıç Deneyimlerimiz
Amaç: Robot yardımlı laparoskopik radikal prostatektomi (RYLRP) sonuçlarımızı sunmak.Yöntem: Şubat 2015 – Aralık 2017 yılları arasında lokalize prostat kanseri (PCa) nedeniyle Sakary Üniversitesi’nde RYLRP operasyonu uygulanan hastaların sonuçları retrospektif olarak değerlendirildi.Bulgular: Hastaların ortalama takip süreleri 16.1 (1-36) ay olarak bulundu. Hastaların ortalama yaşı 64.04 ± 6.33 yıl olarak saptandı. D’Amico risk sınıflamasına göre hastaların 29’u (%60.4) düşük risk, 13’ü (%27.1) orta risk ve 6’sı (%12.5) yüksek risk sınıfında saptandı. Ortalama operasyon süresi 237.7 ± 48.07 dk, ortalama tahmini kan kaybı 190.4 ± 65.8 ml olarak bulundu. Ortalama dren çekilme süresi 3.93 ± 1.81 gün, ortalama hastanede kalış süresi 4.66 ± 1.91 gün, ortalama sonda çekilme süresi 14.1 ± 2.1 gün olarak bulundu. On (%20,8) hastada cerrahi sınır pozitif saptandı. Kontinans oranları postoperatif 1. ay, 6. ay ve 12. ay’da sırasıyla %50, %71.4 ve %85.2 olarak bulundu. Potens oranları postoperatif 1. ay, 6. ay ve 12. ay’da sırasıyla %37.5, %42.9 ve %51.2 olarak tespit edildi. Takiplerde 1 hastada biyokimyasal nüks tespit edildi.Sonuç: RYLRP lokalize PCa’nin tedavisinde etkin ve güvenilir bir yöntemdir. Sonuçlarımız literatürle uyumludur. Cerrahi tecrübe arttıkça daha iyi onkolojik ve fonksiyonel sonuçlar alınacaktır. Anahtar kelime: Öğrenme eğrisi, prostat kanseri, robotik cerrahi.
Robot Assisted Laparoscopic Radical Prostatectomy In Sakarya University: Our Initial Experience
Objective: To present our robot assisted laparoscopic radical prosatatectomy (RALRP) results.Method: The results of patients who underwent RALRP between February 2015 and December 2017 for localized prostate cancer (PCa) at Sakarya University were retrospectively evaluated.Results: Mean follow-up time was 16.1 (1-36) months. The mean patient age was 64.04 ± 6.33 years. According to D’Amico risk classification; 29 (60.4%) patients were found to have low risk, 13 (27.1%) patients have moderate risk and 6 (12.5%) patients have high risk. Mean operation time was 237.7 ± 48.07 min, mean estimated blood loss was 190.4 ± 65.8 ml. Mean draining time was 3.93 ± 1.81 days, mean hospitalization time was 4.66 ± 1.91 days and mean catheterization time was 14.1 ± 2.1 days. Surgical margin positivity was found in 10 (20.8%) patients. The continent rate at postoperative 1th, 6th and 12th months were 50%, 71.4% and 85.2%; respectively. The potency rates at postoperative 1th, 6th and 12th months were 37.5%, 42.9% and 51.2%; respectively. Biochemical recurrence was detected in 1 patient at follow-up period. Conclusion: RALRP is an effective and reliable method for localized PCa treatment. Our results are consistent with the literature. Better oncologic and functional results will be obtained as surgical experience increases.
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