[Deep dorsal vein complex ligation-free technique in robot-assisted radical prostatectomy for prostate cancer].

Abstract

OBJECTIVE: To investigate the application of the deep dorsal vein complex (DVC) ligation-free technique in robot-assisted radical prostatectomy (RARP) and its effects on the intraoperative blood loss, incidence of positive surgical margin (PSM) and urinary continence of the patient. METHODS: Totally 154 PCa patients underwent RARP between October 2015 and June 2019, 40 with the DVC ligation-free technique (group A) and the other 114 by conventional DVC ligation (group B). We compared the baseline characteristics, operation time, intraoperative blood loss, blood transfusion rate, and postoperative incidences of PSM and urinary incontinence immediately and at 1 and 3 months after catheter removal between the two groups. RESULTS: There were no statistically significant differences between the groups A and B in age, body mass index, PCa risk levels or American Scoiety of Anesthesiology (ASA) tumor grades (P > 0.05), nor in intraoperative blood loss (ΔZ: ［2.11 ± 8.88］ vs ［1.24 ± 14.70］ g/L, P > 0.05), blood transfusion rate (10.0% vs 15.8%, P > 0.05), overall PSM incidence (15.0% vs 15.8%, P > 0.05) or apical PSM rate (7.5% vs 8.8%, P > 0.05). The mean operation time was remarkably shorter in group A than in B (107.20 min vs 113.25 min, P < 0.05) and the postoperative incidence rate of urinary incontinence was markedly lower in the former than in the latter group immediately after (2.5% vs 17.5%, P < 0.05) and at 1 month after catheter removal (0 vs 14.0%, P < 0.05), but with no statistically significant difference between the two groups at 3 months (0 vs 7.9%, P > 0.05). CONCLUSIONS: The DVC ligation-free technique in RARP can reduce the operation time and promote the recovery of urinary continence in PCa patients without increasing intraoperative blood loss and the incidence of PSM.