比较接受机器人辅助腹腔镜前列腺切除术 (RALP) 并进行神经血管结构邻近冰冻切片检查 (NeuroSAFE) 的男性与接受 RALP 但不进行 NeuroSAFE（标准护理 [SOC]）的男性的 1 年功能和 5 年肿瘤学结果）。2009 年 1 月 1 日至 2018 年 6 月 30 日期间在我们中心接受 RALP 的男性是从前瞻性维护的数据库中登记的。如果患者接受了术前治疗或术后辅助治疗或参加了临床试验，则被排除在外。根据 NeuroSAFE 的使用情况对患者进行分组。随访时间为 5 年。主要结果是多变量分析中生化复发时间 (BCR) 的差异，定义为连续两次测量的前列腺特异性抗原 (PSA) >0.2ng/L。次要结局是 1 年勃起功能障碍和尿失禁方面的差异。 在入组期间，连续 1199 名男性接受了 RALP，其中 1140 名符合资格，其中 317 名接受 NeuroSAFE，823 名接受 SOC。两组的中位 PSA 随访时间均为 60 个月。 Kaplan-Meier 生存曲线分析中的 5 年 BCR 率相似（11% vs 11%；P = 0.9），多变量 Cox 比例风险模型中的 BCR 时间也相似（风险比 1.2；P = 0.6）。 1 年时与 SOC 组相比，NeuroSAFE 组的未调整失禁率相似（5.1% vs 7.7%），未调整阳痿率较低（57% vs 80%）。多变量分析显示，NeuroSAFE 患者的尿失禁风险相当（比值比 [OR] 0.59，95% CI 0.17-1.6；P = 0.4），但勃起功能障碍的风险显着降低（OR 0.37，95% CI 0.22-0.60；P < 0.001)。对于接受 RALP 的男性，与 SOC 相比，NeuroSAFE 患者的 BCR 时间和 1 年失禁风险相当，并且 1 年勃起功能障碍的风险显着降低。© 2024 作者。 BJU International 约翰·威利 (John Wiley) 出版

To compare 1-year functional and 5-year oncological outcomes of men undergoing robot-assisted laparoscopic prostatectomy (RALP) with neurovascular structure-adjacent frozen-section examination (NeuroSAFE) with those in men undergoing RALP without NeuroSAFE (standard of care [SOC]).Men undergoing RALP in our centre between 1 January 2009 and 30 June 2018 were enrolled from a prospectively maintained database. Patients were excluded if they had undergone preoperative therapy or postoperative adjuvant therapy or were enrolled in clinical trials. Patients were grouped based on use of NeuroSAFE. Follow-up was censored at 5 years. The primary outcome was difference in time to biochemical recurrence (BCR) on multivariable analysis, defined as prostate-specific antigen (PSA) >0.2 ng/L on two consecutive measurements. Secondary outcomes were difference in 1-year erectile dysfunction and incontinence.In the enrolment period, 1199 consecutive men underwent RALP, of whom 1140 were eligible, including 317 with NeuroSAFE and 823 with SOC. The median PSA follow-up was 60 months in both groups. Rates of 5-year BCR were similar on Kaplan-Meier survival curve analysis (11% vs 11%; P = 0.9), as was time to BCR on multivariable Cox proportional hazards modelling (hazard ratio 1.2; P = 0.6). Compared with the SOC group at 1 year, the NeuroSAFE group had similar unadjusted rates of incontinence (5.1% vs 7.7%) and lower unadjusted impotence (57% vs 80%). On multivariable analysis, NeuroSAFE patients had equivalent risk of incontinence (odds ratio [OR] 0.59, 95% CI 0.17-1.6; P = 0.4) but significantly reduced risk of erectile dysfunction (OR 0.37, 95% CI 0.22-0.60; P < 0.001).For men undergoing RALP, compared with SOC, NeuroSAFE patients had equivalent time to BCR and risk of 1-year incontinence, and significantly lower risk of 1-year erectile dysfunction.© 2024 The Author(s). BJU International published by John Wiley & Sons Ltd on behalf of BJU International.