Sažetak
Minimalno invazivne tehnike, uključujući robotski-potpomognutu i laparoskopsku radikalnu prostatektomiju postale su operativne tehnike izbora za operativno lečenje karcinoma prostate. Cilj studije bio je proceniti i uporediti rezultate laparoskopske radikalne prostatektomije (LRP) i otvorene retropubične radikalne prostatektomije (ORRP) u pogledu bezbednosti, efikasnosti i onkološkog ishoda.
Ukupno 123 radikalne prostatektomije (RP) za nisko-rizični lokalizovani karcinom prostate obavljene su u periodu od januara 2016. do juna 2019. na Univerzitetskoj klinici za urologiju Skoplje. Od toga je 61 (49,6%) bila LRP, a 62 (50,4%) ORRP, uz prosečnu starost pacijenata 54 godine (33 do 67). Indikacije za operativni postupak bile su: patohistološki nalaz adenokarcinoma prostate, starost ≤ 70 godina, PSA <10ng/ml, Gleson-skor ≤ 7 (3 + 3 ili 3 + 4), negativna scintigrafija kostiju, stadijum ≤T2a, N0, M0. Svi pacijenti su sagledani kroz demografske podatke, nivoe PSA, Gleason-skora, trajanja operactivnog zahvata, konverzije iz LRP u ORRP, gubitaka krvi, perioperativnih komplikacija, uklanjanja operativnog katetera, transfuzija krvi, boravka u bolnici i onkološkog ishoda.
LRP se pokazao superiornijim u odnosu na ORRP, što je rezultovalo kraćim operativnim vremenom, manjim gubicima krvi (p < 0.5), kraćim vremenom za nastavak oralnog unosa hrane i tečnosti, kraćim postoperativnim boravkom u bolnici (p < 0.5) i manjim potrebama za analgetskom terapijom. Što se tiče onkološkog ishoda, primetili smo manje pozitivnih resekcionih ivica u grupi LRP (p < 0.5). Naši rezultati pokazuju da iako obe operativne tehnike predstavljaju bezbedne procedure i pružaju dobar kvalitet operativnog zahvata, u našoj seriji LRP je pokazala bolje rezultate u pogledu bezbednosti, efikasnosti i onkološkog ishoda.
Ključne reči
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