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Prostatectomía radical robótica: análisis después de 100 casos en la fundació puigvert
Robotic radical prostatectomy: first 100 patients in fundació puigvert
Humberto Villavicencio mavricha,1
Autor para correspondencia
hvillavicencio@fundacio-puigvert.es

Correspondencia autor: Dr. Humberto Villavicencio Mavrich Servicio de Urología. Fundació Puigvert Cartagena, 340-350 - 08025 Barcelona Tel.: 934 169 700
, Salvador Esquena fernándeza, José Salvador bayarria, N. De graevea, Juan J. Gómez ruiza, P. Escovar larivaa, Juan Palou redortaa
a Servicio de Urología. Fundació Puigvert. Barcelona
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Realizar un an&#225;lisis de los primeros 100 casos de nuestra serie de prostatectom&#237;a radical rob&#243;tica con Da Vinci &#40;PRRdaV&#41; realizadas en nuestro Centro&#44; que corresponden a la primera serie en Espa&#241;a&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realiza un estudio retrospectivo de las 100 primeras PRRdaV consecutivas realizadas en la Fundaci&#243; Puigvert entre Julio de 2005 y Enero de 2007&#46; El procedimiento fue realizado por 5 cirujanos distintos&#44; siendo la curva de aprendizaje para todos ellos&#46; El abordaje fue transperitoneal en todos los casos&#46; Se analizan&#44; tiempo operatorio&#44; p&#233;rdidas hem&#225;ticas&#44; tasa de conversi&#243;n&#44; complicaciones intra y postoperatorias&#44; estancia hospitalaria y d&#237;as de sonda vesical&#46; Tambi&#233;n se revisan las tasas y la localizaci&#243;n de los m&#225;rgenes positivos&#44; as&#237; como los resultados funcionales&#44; con un seguimiento medio de 10&#44;3 meses&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La media de tiempo operatorio fue de 180 minutos &#40;100-310&#41; y la p&#233;rdida hem&#225;tica media de 210 mL &#40;100- 390&#41;&#46; En 2 casos se realiz&#243; transfusi&#243;n postoperatoria&#46; No se presentaron complicaciones intraoperatorias&#44; y tampoco ninguna reconversi&#243;n&#46; Como acontecimientos postoperatorios destacan un s&#237;ndrome compartimental&#44; una retenci&#243;n aguda urinaria tras retirada de sonda vesical&#44; y unas parestesias por compresi&#243;n del plexo braquial&#46; La estancia hospitalaria media fue 3&#44;7 d&#237;as &#40;2-21&#41;&#46; Se obtuvieron 21 casos con m&#225;rgenes quir&#250;rgicos positivos &#40;21&#37;&#41;&#46; La localizaci&#243;n m&#225;s frecuente fue posterolateral&#46; El 69&#37; fueron continentes de forma precoz &#40;&#60;3 meses&#41;&#44; el 91&#37; lo fueron a los 9 meses&#44; el 9&#37; restante requiere de compresa de seguridad&#46; Referente a la funci&#243;n sexual&#44; el 62&#37; conservan potencia y el 38&#37; presentaron disfunci&#243;n er&#233;ctil postoperatoria&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La PRRdaV es un procedimiento seguro&#44; reproducible y que ofrece unos resultados oncol&#243;gicos y funcionales muy prometedores con un abordaje m&#237;nimamente invasivo&#46; A pesar de incluir la curva de aprendizaje de 5 cirujanos&#44; obtenemos una excelente tasa de continencia&#44; y una buena funci&#243;n sexual&#46; La mejora individual&#44; con mayor experiencia&#44; as&#237; como un mayor seguimiento&#44; permitir&#225; valorar la evoluci&#243;n de la t&#233;cnica&#44; as&#237; como de sus resultados&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We present the 100 first robotic radical prostatectomy with Da Vinci &#40;RRPdaV&#41;&#44; corresponding to the first experience in Spain&#46;</p> <span class="elsevierStyleSectionTitle">methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We reviewed the first 100 patients that underwent transperitoneal RRPda performed in Fundaci&#243; Puigvert between July 2005 and January 2007&#46; All cases were performed by 5 surgeons&#44; being the learning curve for all of them&#46; We analyzed surgical time&#44; blood loss&#44; conversion rate&#44; intra and postoperative complications&#44; hospital stay and days of bladder catheterization&#46; Also&#44; rates and location of surgical margins&#44; as well as functional outcomes with an average follow up of 10&#46;3 months&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mean operating time was 180 minutes &#40;100-310&#41; and blood loss 210 mL &#40;100-390&#41;&#46; Blood transfusion was required in 2 cases&#46; There were no intraoperative complications and neither any conversion to open surgery&#46; There were 3 outstanding postoperative events&#44; a compartmentalize syndrome&#44; an acute urinary retention after removal of urethral catheter&#44; and a paresthesias due to brachial plexus compression&#46; Mean hospital stay were 3&#46;7 days&#46; &#40;2-21&#41;&#46; We had 21 cases of positive surgical margins &#40;21&#37;&#41;&#46; The most frequent location was posterior lateral&#46; 69 of 100 patients &#40;69&#37;&#41; reached early &#40;&#60;3 months&#41; total continence&#44; 91&#37; achieved in 9 months&#44; and remaining 9&#37; required use of at least one pad&#46; Concerning to sexual function&#44; 13 of 100 patients &#40;13&#37;&#41; had preoperative erectile dysfunction&#44; of remaining cases&#44; 62&#37; preserved potency at review&#44; and 38&#37; had postoperative erectile dysfunction&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">RRPDAv is a safe and reproducible procedure&#44; and offers promising oncological and functional results with a minimal invasive technique&#46; In spite of include the learning curve of 5 surgeons&#59; we obtain an excellent rate of continence&#44; and an acceptable sexual function&#46; The individual improvement&#44; with more experience&#44; and a longer follow-up&#44; will allow to value evolution of the technique&#44; and it results&#46;</p>"
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Información del artículo
ISSN: 02104806
Idioma original: Español
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es en pt

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Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos