Radical prostatectomy is a commonly used surgical method in cases of localized prostate cancer.In recent years,with the advent of new medical technologies and surgical techniques,the evolution of radical prostatectomy has revolutionized,especially in robot-assisted radical prostatectomy(RARP).The evolution of surgical approaches for radical prostatectomy has occurred in three stages:open surgery,laparoscopic intervention,and robot-assisted surgery.Regarding the functional recovery of patients who underwent laparoscopic radical prostatectomy or RARP,with the improvement of disease conditions,oncological prognosis of patients was not compromised.Particularly,RARP boasts distinguished novel techniques and approaches for maintaining urinary continence and sexual function in the short-and long-term.In addition,studies in the last two decades have shown its correlation with decreasing postoperative morbidity.In this paper,the available literatures related to the surgical approaches ranging from open surgery to RARP were reviewed,the superiority of any novel procedure was analyzed,and the advantages and disadvantages among the three modalities were compared,hoping to provide guidance to urologists when considering surgical approaches in the treatment of localized prostate cancer.
LI HengpingZHANG MaoZHANG XiangxiangWANG XiangrongLI HaiyangLIU YangLI XuanpengZHOU PengMA Rong
前列腺癌是男性恶性肿瘤中最常见的肿瘤之一,目前根治性前列腺切除术是治疗器官局限性及局部进展期前列腺癌的最主要手段。然而在手术后部分患者会出现切缘阳性,这有可能导致前列腺癌的生化复发甚至临床进展,因此有效的治疗和预测策略对改善患者预后至关重要。本文概述切缘阳性患者在根治前列腺切除后的最新诊治及预后,为这类病人的预防和治疗提供思路。Radical prostatectomy is the primary treatment for organ-confined and locally advanced prostate cancer, a malignancy that is one of the most frequent among men. Despite the possibility of positive surgical margins postoperatively, this may result in biochemical recurrence or even a clinical progression of prostate cancer. Therefore, effective treatment and predictive strategies are crucial for improving patient outcomes. The aim of this article is to provide an overview of the most recent progressions in diagnosing, treating, and forecasting those with positive surgical margins after radical prostatectomy, thereby offering insight into how to avert and treat them.
