Abstract

Purpose

Open simple prostatectomy (OSP) is a standard surgical technique for patients with benign prostatic hyperplasia with prostate size larger than 80 ml. As a minimally invasive approach, robot-assisted simple prostatectomy (RASP) emerged as a feasible surgical alternative. Currently, there are no definite recommendations for the standard use of RASP. Therefore, we aimed at investigating various clinical outcomes comparing RASP with OSP.

Methods

In this retrospective single-center study, we evaluated clinical data from 103 RASP and 31 OSP patients. Both cohorts were compared regarding different clinical characteristics with and without propensity score matching. To detect independent predictive factors for clinical outcomes, multivariate logistic regression analysis was performed.

Results

Robot-assisted simple prostatectomy patients demonstrated a lower estimated blood loss and need for postoperative blood transfusions as well as less postoperative complications. OSP had a shorter operative time (125 min vs. 182 min) longer hospital stay (11 days vs. 9 days) and longer time to catheter removal (8 days vs. 6 days). In the multivariate analysis, RASP was identified as an independent predictor for longer operative time, lower estimated blood loss, shorter length of hospital stay, shorter time to catheter removal, less postoperative complications and blood transfusions.

Conclusion

Robot-assisted simple prostatectomy is a safe alternative to OSP with less perioperative and postoperative morbidity. Whether OSP (shorter operative time) or RASP (shorter length of hospital stay) has a more favorable economic impact depends on the particular conditions of different health care systems. Further prospective comparative research is warranted to define the value of RASP in the current surgical management of benign prostatic hyperplasia.

中文翻译：

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机器人辅助的简单前列腺切除术与开放式简单前列腺切除术：单中心比较

摘要

目的

开放性单纯前列腺切除术 (OSP) 是前列腺大小大于 80 毫升的良性前列腺增生患者的标准手术技术。作为一种微创方法，机器人辅助的简单前列腺切除术 (RASP) 成为一种可行的手术替代方案。目前，对于 RASP 的标准使用没有明确的建议。因此，我们旨在研究比较 RASP 与 OSP 的各种临床结果。

方法

在这项回顾性单中心研究中，我们评估了 103 名 RASP 和 31 名 OSP 患者的临床数据。在有和没有倾向评分匹配的情况下，比较两个队列的不同临床特征。为了检测临床结果的独立预测因素，进行了多变量逻辑回归分析。

结果

机器人辅助的简单前列腺切除术患者表现出较低的估计失血量和术后输血需求以及较少的术后并发症。OSP 的手术时间更短（125 分钟对 182 分钟），住院时间更长（11 天对 9 天）和导管移除时间更长（8 天对 6 天）。在多变量分析中，RASP 被确定为手术时间更长、估计失血量更低、住院时间更短、导管拔除时间更短、术后并发症和输血更少的独立预测因子。

结论

机器人辅助的简单前列腺切除术是 OSP 的安全替代方案，围手术期和术后发病率较低。OSP（更短的手术时间）或 RASP（更短的住院时间）是否具有更有利的经济影响取决于不同医疗保健系统的特定条件。需要进一步的前瞻性比较研究来确定 RASP 在当前良性前列腺增生手术治疗中的价值。