Prostate cancer is one of the most commonly diagnosed malignancies worldwide and is a major cause of cancer-associated morbidity in men. Radical prostatectomy (RP) is a cornerstone of intervention for organ-confined diseases and offers a potentially curative outcome. In recent decades, RP has undergone transformative changes, moving from open surgery, with significant morbidity, to minimally invasive and robot-assisted techniques. These advances have improved surgical precision, reduced blood loss, and accelerated functional recovery. Key enhancements, such as the “Veil of Aphrodite”, hood-sparing, and Retzius-sparing approaches, aim to preserve neurovascular structures vital for continence and sexual function, addressing the persistent challenge of balancing oncological control with quality-of-life outcomes. Single-port (SP) robotic platforms represent the latest frontier, offering various access routes, including extraperitoneal, transvesical, transperitoneal, and transperineal routes, to further reduce incisional morbidity. Early experiences with SP robot-assisted radical prostatectomy(RARP) suggest favorable continence rates and short hospital stays, although concerns remain regarding the technical complexity and potential margin status of the advanced disease. Comparisons across these techniques revealed broadly similar long-term oncological outcomes, underscoring the importance of patient selection, tumor staging, and surgeon expertise. Ongoing innovations in robotic systems, augmented imaging modalities, and personalized surgical planning are likely to refine prostate cancer care and enhance both survival and post-treatment quality of life.
前列腺癌是全球范围内最常见的恶性肿瘤之一，也是导致男性癌症相关疾病负担的主要原因。根治性前列腺切除术（RP）是器官局限性前列腺癌干预治疗的基石，具有潜在的治愈效果。近几十年来，RP技术经历了革命性变革，从创伤较大的开放手术发展为微创及机器人辅助技术。这些进步提高了手术精确度，减少了术中失血，并加速了功能恢复。诸如“阿芙罗狄蒂之幕”、筋膜保留及Retzius间隙保留等关键技术创新，旨在保护对控尿功能和性功能至关重要的神经血管结构，从而应对在肿瘤控制与生活质量之间取得平衡这一长期挑战。单孔（SP）机器人平台代表了最新技术前沿，通过提供包括腹膜外、经膀胱、经腹膜及经会阴等多种入路方式，进一步降低了切口相关并发症。早期SP机器人辅助根治性前列腺切除术（RARP）的临床实践显示其具有较好的控尿恢复率和较短的住院时间，但该技术在处理晚期疾病时的操作复杂性及切缘状态仍存在争议。不同术式的比较研究表明其长期肿瘤学结局总体相似，这凸显了患者选择、肿瘤分期及外科医生专业能力的重要性。机器人系统的持续创新、增强成像模式的应用以及个性化手术规划的推进，有望进一步优化前列腺癌治疗，提升患者生存率及治疗后生活质量。
Recent Advances in Radical Prostatectomy: A Narrative Review of Surgical Innovations and Outcomes
肿瘤(癌症)患者之家