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임상적으로 진행된 전립선암에 대한 개복과 로봇 근치적 전립선적출술의 비교

Comparison of Open versus Robotic Radical Prostatectomy in Clinically Advanced Prostate Cancer

대한비뇨기과학회지 2008년 49권 10호 p.886 ~ 892
함원식 ( Ham Won-Sik ) - 연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소

나군호 ( Rha Koon-Ho ) - 연세대학교 의과대학 비뇨기과학교실
박성열 ( Park Sung-Yul ) - 연세대학교 의과대학 비뇨기과학교실
최영득 ( Choi Young-Deuk ) - 연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소

Abstract


Purpose: To evaluate the outcomes of robotic prostatectomy(RP) compared with open radical prostatectomy(OP) in clinically advanced prostate cancer(PC).

Materials and Methods: Between January 2003 and June 2007 we performed radical prostatectomy in 180 patients with clinically advanced PC (OP, 88; RP, 92). We compared the perioperative parameters and early surgical outcomes between the OP and RP groups in patients with and without neoadjuvant hormonal therapy(NHT).

Results: In patients without NHT, there were no significant differences in preoperative characteristics between the OP and RP groups, but in patients with NHT, the RP patients had higher biopsy Gleason scores(GS) and clinical stages. There were no significant differences in lymph node (LN) invasion and extracapsular extension(ECE), but a significant difference existed in the prostatectomy GS between the OP and RP groups, regardless of NHT. The positive surgical margin rates in the RP group were similar to or lower than in the OP groups when stratified by pathologic stages T2 and T3. Irrespective of NHT, in the RP group the mean estimated blood loss was decreased, the mean duration of the hospital stay was less, and the length of bladder catheterization was shorter, but there were no significant differences in the postoperative day the regular diet was started or the frequency of complications. Although there were no significant differences in continence rates between the two groups, all the RP patients had a higher continence rate from 1 month postoperatively, with or without NHT.

Conclusions: Our results suggest that RP may be performed safely and may have results comparable to OP in clinically advanced PC.

키워드

Prostatic neoplasms;Open radical prostatectomy;Robotic radical prostatectomy
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