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目的:探讨前入路保留部分Retizus间隙的机器人辅助腹腔镜根治性前列腺切除术(PRS-RARP)的安全性和有效性。方法:回顾性分析2018年11月至2019年11月东南大学附属中大医院收治的123例前列腺癌患者的临床资料。根据术式分为PRS-RARP组55例和机器人辅助腹腔镜根治性前列腺切除术(RARP)组68例。PRS-RARP组和RARP组的年龄分别为(67.1±6.5)岁和(68.9±6.4)岁，体质指数分别为(24.9±5.2)kg/mn 2和(23.4±3.6)kg/mn 2，前列腺体积分别为(48.7±10.4)ml和(46.5±12.2)ml，术前PSA分别为(28.2±5.4)ng/ml和(26.6±4.1)ng/ml，差异均无统计学意义(n P>0.05)。PRS-RARP组和RARP组Gleason评分≤6分、7分、≥8分分别为17例和22例、31例和38例、7例和8例；临床分期≤cTn 2a期、cTn 2b期、≥cTn 2c期分别为14例和18例、18例和22例、23例和28例，差异均无统计学意义(n P>0.05)。PRS-RARP组手术改进包括：完整保留膀胱腹膜反折、脐正中韧带及脐内侧韧带，保留1侧盆筋膜，背深静脉复合体(DVC)免缝扎，恢复盆腔腹膜的完整性。比较两组的术中失血量、手术时间、并发症、术后肠梗阻和腹股沟疝发生率、尿控恢复情况、切缘阳性率及术后PSA水平等。n 结果:本组123例手术均顺利完成，无中转开放手术。PRS-RARP组无中转RARP者。PRS-RARP组和RARP组手术时间分别为(136.9±13.1)min和(140.6±9.2)min，术中出血量分别为(121.5±26.7)ml和(130.9±31.3)ml，切缘阳性率分别为9.1%(5例)和10.3%(7例)，差异均无统计学意义(n P>0.05)。PRS-RARP组术后无肠梗阻和腹股沟疝发生，RARP组肠梗阻和腹股沟疝发生率分别为4.4%(3/68)和5.9%(4/68)，两组比较差异无统计学意义(n P>0.05)。PRS-RARP组术后1个月和6个月尿控恢复率分别为90.9%(50/55)和96.4%(53/55)，显著高于RARP组的73.5%(50/68)和82.4%(56/68)(n P0.05). Surgical improvements included preservation of the bladder-peritoneum reflex, median umbilical ligament and medial umbilical ligament, preservation of one side of the pelvic fascia, no dorsal vein complex (DVC) suture and restoration of the integrity of the pelvic peritoneum. The intraoperative blood loss, operation time, complications, incidence of postoperative intestinal obstruction and inguinal hernia, recovery of urinary control, positive rate of surgical margin and PSA level between the two groups were compared.n Results:All 123 cases of surgery were completed, without conversion to open surgery. None of the 55 PRS-RARP cases converted to standard RARP. The operative time of PRS-RARP and RARP was (136.9±13.1) minutes and (140.6±9.2) minutes respectively.The intraoperative blood loss of the two groups was (121.5±26.7)ml and (130.9±31.3)ml respectively.The number of cases with positive surgical margin was 5(9.1%)and 7(10.3%)respectively. For the above data, there was no significant difference between different operation methods (n P>0.05). No intestinal obstruction and inguinal hernia occurred in the PRS-RARP group after surgery, while the incidence of intestinal obstruction and inguinal hernia in the RARP group were 4.4%(3/68) and 5.9%(4/68)respectively (n P>0.05). The ratios of urinary control recovery in the PRS-RARP group within 1 month and 6 months were 90.9%(50/55) and 96.4%(53/55) respectively, which was significantly higher than 73.5%(50/68) and 82.4%(56/68) of RARP group (n P<0.05). After 10-22 months of follow-up, PSA was<0.2 ng/ml.n Conclusions:Compared with RARP, PRS-RARP might help to restore peritoneal integrity, and prevent the occurrence of operation-related intestinal obstruction and inguinal hernia, and might help the recovery of urinary control.