Açık, Laparoskopik ve Robotik Radikal Prostatektomi Yöntemleri
Özet
Bu çalışma, prostat kanseri cerrahi tedavisinde kullanılan açık (retropubik ve perineal), laparoskopik (ekstraperitoneal ve transperitoneal) ve robot yardımlı laparoskopik radikal prostatektomi yöntemlerini ve cerrahi tekniklerini incelemektedir. Kanser kontrolü, inkontinansın engellenmesi ve cinsel fonksiyonların korunması cerrahinin üç temel amacıdır. Retropubik yöntem en eski ve yaygın metotlardan biriyken, perineal yaklaşım daha az bilinmekle birlikte dorsal venöz kompleksi kesmeyi gerektirmemesi gibi avantajlara sahiptir. Teknolojik ilerlemelerle gelişen laparoskopik ve robotik teknikler, daha net üç boyutlu görüntü, hassas diseksiyon ve daha iyi kanama kontrolü sağlayarak popülerlik kazanmıştır. Hangi yöntem seçilirse seçilsin, pozitif cerrahi sınır riskini azaltmak, nörovasküler demeti korumak ve üreter orifisleri ile üretral sfinktere zarar vermemek ameliyat başarısı açısından kritik öneme sahiptir.
This study examines open (retropubic and perineal), laparoscopic (extraperitoneal and transperitoneal), and robot-assisted laparoscopic radical prostatectomy methods and surgical techniques used in the surgical treatment of prostate cancer. Cancer control, prevention of incontinence, and preservation of sexual functions are the three primary goals of the surgery. While the retropubic method is one of the oldest and most common techniques, the perineal approach is less widely known but offers advantages such as eliminating the need to incise the dorsal venous complex. Laparoscopic and robotic techniques, which have evolved with technological advancements, have gained popularity by providing clearer three-dimensional vision, precise dissection, and better bleeding control. Regardless of the chosen method, reducing the risk of positive surgical margins, preserving the neurovascular bundle, and avoiding damage to the ureteral orifices and urethral sphincter are of critical importance for surgical success.
Referanslar
Mottet N, van den Bergh RCN, Briers E et all. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer-2020 Update. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2021;79(2):243-262. doi: 10.1016/j.eururo.2020.09.042
AJ Wein, LR Kavoussi, AC Novick et all. Campbell-Walsh urology: expert consult premium edition: enhanced online features and print, 4-volume set.
Jewett HJ. Radical perineal prostatectomy fo rcarcinoma: an analysis of cases at Johns Hopkins Hospital, 1904-1954.J AmMedAssoc. 1954 13;156(11):1039-1041. doi: 10.1001/jama.1954.02950110001001
Heinzer H, Graefen M, Noldus et all. Early complication of anatomical radical retropubic prostatectomy: lessons from a single-center experience. Urol Int. 1997;59(1):30-33. doi: 10.1159/000283013
Eggleston JC, Walsh PC. Radical prostatectomy with preservation of sexual function: pathological findings in the first 100 cases. J Urol. 1985;134(6):1146-1148. doi: 10.1016/s0022-5347(17)47661-0
H Lepor. Radical retropubic prostatectomy UrolClin North Am .2001 ;28(3):509-519, viii. doi: 10.1016/s0094-0143(05)70159-2
Young HH: The early diagnosis and radical cure of carcinoma of the prostate. Johns Hopkins HospBull 1905; 16:315-321.
Polascik TJ, Walsh PC. Radical retropubic prostatectomy: the influence of accessory pudendal arteries on there covery of sexual function. J Urol. 1995;154(1):150-152. doi: 10.1016/s0022-5347(01)67252-67255
Bishoff JT, Motley G, Optenberg SA et all. Incidence of fecal and urinary incontinence following radical perineal and retropubic prostatectomy in a national population. The Journal of Urology. 1998; 160(2):454-458
Sullivan LD, Weir MJ, Kinahan JF et all. A comparison of the relative merits of radical perineal and radical retropubic prostatectomy. BJU Int. 2000 Jan;85(1):95-100. doi: 10.1046/j.1464-410x.2000.00405.x
Pasticier G, Rietbergen JB, Guillonneau B et all: Robotically assisted laparoscopic radical prostatectomy: feasibility study in men. EurUrol. 2001; 40: 70-74.
