机器人辅助根治性前列腺切除术疗效分析  

Efficacy analysis of robotic-assisted laparoscopic radical prostatectomy

作　　者：丁强[1] 李宏召[1] 张旭[1] 王保军[1] 马鑫[1] 瓦斯里江.瓦哈甫 杨国强[1] 郑涛[1] 

机构地区：[1]中国人民解放军总医院泌尿外科,北京100853

出　　处：《微创泌尿外科杂志》2013年第3期166-168,共3页Journal of Minimally Invasive Urology

摘　　要：目的:探讨机器人辅助根治性前列腺切除术(RALP)的安全性和有效性.方法:回顾性分析由单一术者(张旭)于2008年1月～2013年1月RALP并且有完整临床资料和随访结果的187例患者.对比围手术期资料以及术后随访情况.结果:187例均手术成功.手术时间平均为149 min,术中出血量平均178 ml,拔出尿管时间平均10d,输血14例(7.49％);1例直肠损伤(0.53％);1例套管损伤腹壁肌间动脉(0.53％);1例术后第6天出现心源性猝死(0.53％);34例术后吻合口漏尿(18.28％);3例术后吻合口狭窄(1.61％),2例行尿道扩张,1例行狭窄段电切后治愈.病理切缘阳性63例(33.87％);37例(19.79％)高危患者行双侧淋巴结清扫;保留性神经182例(97.32％);2年内控尿满意176人(94.63％);性功能恢复155例(83.33％),术后生化复发9例(4.84％).结论:机器人辅助腹腔镜根治性前列腺切除术安全可靠,能够精准的处理微细结构,患者住院时间短,恢复快,应用前景广阔.Objective:To evaluate the efficiency and safety of robotic-assisted laparoscopic radical prostatectomy(RALP).Methods:We retrospectively reviewed the complete clinical and follow-up data of 187cases.Results:All 187cases received successful operation.Average operative time was 149.5min with an estimated blood loss of 178 ml.The foley catheter was removed on postoperative day 10.14cases needed transfusion.One case sustained rectal injury,one met abdominal artery injury.One case suffered sudden cardiac death 6days after operation.34cases were found urinary leakage.The positive surgical margin rate was 33.87%.Pelvic lymph node dissection was introduced to 37high-risk cases.182cases were offered nerve-sparing surgery.3cases developed anastomotic stricture,2 cases requiring dilatation and 1case need transurethral resection.The continence rate was 94.63% within 2years. The potency rate was 83.33%.Biochemical recurrence rate was 4.84%.Conclusions:Robotic-assisted laparoscopic radical prostatectomy is safe and reliable,with advantage of shorter hospitalization,less blood loss.It can dispose the slight anatomic structure precisely,which has good perspective.

关 键 词：机器人辅助手术 前列腺癌 治疗 腹腔镜 

分 类 号：R737[医药卫生—肿瘤]