目的：探讨局限性前列腺癌患者采用改良 Vattikuti 研究所前列腺切除术（VIP）技术行机器人辅助腹 腔镜下根治性前列腺切除术（RARP）治疗的临床疗效。方法：回顾性分析 2022 年 1 月—2023 年 6 月在宝鸡市中心 医院泌尿外科行 RARP 的 53 例局限性前列腺癌患者的临床资料。根据手术方式不同，分为标准前入路 RARP（SARARP）组和改良 VIP RARP（MV-RARP）组，其中 SA-RARP 组 24 例，MV-RARP 组 29 例。收集并比较两组患者 围手术期指标及术后随访资料。结果：两组患者均顺利完成手术，未出现中转开放手术及二次手术，两组一般资料 比较，差异均无统计学意义（P>0.05）。两组患者的手术时间、术中出血量、术中输血率、术后住院时间、术后引 流管拔除时间、术后导尿管拔除、切缘阳性率、扩大淋巴结清扫率、淋巴结阳性率、Gleason 评分、临床分期比较， 差异无统计学意义（P>0.05）。与 SA-RARP 组相比，MV-RARP 组即刻尿控、早期尿控及 3 个月尿控恢复情况均更优， IIEF-5 评分更高（P<0.05）。采用 Kaplan-Meier 生存曲线分析两组患者无生化复发生存时间，差异无统计学意义 （Log-Rank：χ 2 =0.889，P=0.346）。采用Kaplan-Meier生存曲线分析两组患者尿控恢复率，差异有统计学意义（Log-Rank： χ 2 =4.314，P=0.038）。结论：改良 VIP 技术是一种精准、安全的前列腺癌根治技术，可以在保证良好肿瘤控制的基 础上，提高术后早期尿控恢复率，改善术后勃起功能。

Objective: To investigate the clinical efficacy of modified Vattikuti Institute Prostatectomy (VIP) technique in patients underwent robot-assisted laparoscopic radical prostatectomy (RARP) for localized prostate cancer. Methods: Clinical data of 53 patients with localized prostate cancer who underwent RARP in Baoji Central Hospital from January 2022 to June 2023 were retrospectively analyzed. According to the different surgical approaches, they were divided into the standard anterior approach robot-assisted laparoscopic radical prostatectomy (SA-RARP) group (n=24) and modified VIP RARP (MV-RARP) group (n=29). Perioperative indicators and follow-up data were collected and compared between the two groups. Results: All surgeries were successfully completed without conversion to open surgery or secondary surgery. There were no statistically significant differences in general data of patients in the two groups (P>0.05). The differences in operative time, intraoperative bleeding, intraoperative blood transfusion rate, postoperative hospitalization time, drainage tube removal time, postoperative catheter removal, positive surgical margin rate, enlarged lymph node dissection rate, positive lymph node rate, Gleason score, and clinical stage of the two groups were not statistically significant (P>0.05). Compared with the SA-RARP group, the MVRARP group had better immediate urinary control, early urinary control and 3-month urinary control, and higher IIEF-5 score (P<0.05). Kaplan-Meier curve was used to analyze the survival time without biochemical recurrence in the two groups, and the difference was not statistically significant (Log-Rank：χ 2 =0.889, P=0.346). The Kaplan-Meier survival analysis indicated that the difference in recovery rate of urinary control of the two groups was statistically significant (Log-Rank：χ 2 =4.314, P=0.038). Conclusion: The modified VIP technique is a precise and safe technique in RARP for prostate cancer, which can improve the recovery rate of early postoperative urinary control and postoperative erectile function by ensuring good tumor control.

收稿日期：2024-02-06  录用日期：2024-04-28 

Received Date: 2024-02-06  Accepted Date: 2024-04-28 

基金项目：陕西省卫生健康科研基金项目（2021C002） 

Foundation Item: Health Research Founding project of Shaanxi Province (2021C002) 

通讯作者：罗晓辉，Email：luoxiaohuidoctor@163.com 

Corresponding Author: LUO Xiaohui, Email: luoxiaohuidoctor@163.com 

引用格式：黄晓东，王晨青，樊俊杰，等 . 改良 VIP 技术在机器人辅助腹腔镜下根治性前列腺切除术中的应用研究（附手术视频）[J]. 机器人外科学杂志（中英文），2024，5（6）：1047-1055. 

Citation: HUANG X D, WANG C Q, FAN J J, et al. Application of modified VIP technique in robot-assisted laparoscopic radical prostatectomy (with surgical video)[J]. Chinese Journal of Robotic Surgery, 2024, 5(6): 1047-1055.

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