经腹膜外途径腹腔镜前列腺癌根治术5年疗效分析  

Efficacy analysis of extra-peritoneal laparoscopic radical prostatectomy for 5 years

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

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4期253-255,共3页Journal of Minimally Invasive Urology

摘　　要：目的:探讨经腹膜外途径腹腔镜前列腺癌根治术(eLRP)治疗前列腺癌的临床疗效和应用价值.方法:对2008年2月~2013年1月由同一术者实施eLRP的256例前列腺癌患者围手术期资料以及术后随访情况对比分析.结果:256例手术均获成功,无中转开放手术病例.手术时间平均108 min;术中出血量平均136 ml;术中输血15例(5.9%);术后引流时间平均4 d;拔除尿管时间平均13 d;术后住院时间平均9 d.1例术中大出血,1例出现直肠损伤,2例术后尿道狭窄,36例术后出现尿外渗(14.1%),34例(13.3%)术后每天使用尿垫超过4块.术后切缘阳性率 19.10%.97例高危患者术中行改良盆腔淋巴结清扫,术后39例生化复发(15.2%),性功能恢复206例(80.5%).结论:eLRP是安全、可行和有效的治疗局限性前列腺癌的方法之一.可避免对腹腔脏器的干扰,缩短患者恢复时间,降低手术并发症.术前对局部进展性前列腺癌进行新辅助内分泌治疗可以为根治性切除肿瘤提供有效帮助,在一定时期内,eLRP仍是治疗局限性前列腺癌的主要微创手段.Objective:To evaluate the efficiency and safety of Extra-peritoneal Laparoscopic Radical Prostatecto- my(eLRP).Methods:We retrospectively reviewed the complete clinical and follow-up data of 256 cases with prostate cancer who undergone eLRP by the same performer from February 2008 to January 2013 in The People's Liberation Army General Hospital.Results:All 256 cases received successful operation.Average operative time was 108 min with an estimated blood loss of 136ml.15cases needed transfusion in operation.The drain was removed on postop- erative day 4 and The foley catheter was removed on postoperative day 13.the Average postoperative hospital stay was 9 days.1case of intraoperative bleeding,1case sustained rectal injury,2cases developed anastomotic stricture, 36cases were found urinary leakage,34 cases of postoperative urine pad used more than 4 pieces every day,The positive surgical margin rate was 19.10%.Pelvic lymph node dissection was introduced to 97 high-risk cases.The potency rate was 80.5%.Biochemical recurrence rate was 15.2%.Conclusions:Extra-peritoneal Laparoscopic Radical Prostatectomy is safe and reliable,which can reduce the surgical complications and have the advantage of shorter hospitaliza- tion and less blood loss.Laparoscopic radical prostatectomy remains a minimally invasive treatment for localized prostate cancer over a period of time.

关 键 词：根治性前列腺切除术 腹腔镜 腹膜外途径 

分 类 号：R737[医药卫生—肿瘤]