单切口腹腔镜前列腺癌根治术治疗早期局灶性前列腺癌(附5例报告)  

Laparoscopic radical prostatectomy via single incision in treatment of early localized prostate cancer:a report of 5 cases

作　　者：徐丹枫[1] 高轶[1] 刘玉杉[1] 崔心刚[1] 车建平[1] 姚亚成[1] 任吉忠[1] 阴雷[1] 滕怀宁[1] 

机构地区：[1]第二军医大学长征医院泌尿外科,全军泌尿外科中心,上海200003

出　　处：《第二军医大学学报》2010年第1期63-65,共3页Academic Journal of Second Military Medical University

摘　　要：目的总结单切口腹腔镜前列腺癌根治术治疗早期局灶性前列腺癌的手术经验。方法2009年6月至8月,我科对5例早期局灶性前列腺癌患者实施单切口腹腔镜前列腺癌根治术。手术采用经腹膜外入路,取脐下约3cm长切口,使用自制Port,插入1枚10mm TROCAR及2枚5mm TROCAR,游离并切除前列腺,吻合膀胱尿道。结果5例腹腔镜前列腺癌根治术均获成功,无一例中转开放手术或传统腹腔镜手术。手术时间135～210min,平均(167±31.5)min;其中前列腺切除用时90～150min,平均(115±26)min,尿道膀胱吻合用时45～60min,平均(52±5.7)min。术中出血量50～200ml,平均(90±62)ml;标本切缘阳性1例。术后1周拔除导尿管,出现短暂尿失禁2例。术后随访4～12周,前列腺特异抗原(PSA)均<0.2μg/L。结论单切口前列腺癌根治术是安全可行的,熟练的腔镜手术技巧和特殊的Port及可弯曲器械是手术成功的关键。Objective To summarize our experience on laparoscopic radical prostatectomy via single incision in treatment of early localized prostate cancer. Methods From June 2009 to August 2009,five patients with localized prostate cancer（ T1c） received laparoscopic radical prostatectomy via single incision. A home-made multichannel port was inserted extraperitoneally through a 3 cm incision under the umbilicus. A 10 mm TROCAR and two 5 mm TROCAR were inserted. The prostate was isolated and excised,then the bladder urethral anastomosis was performed. Results The procedures were successful in all the five cases with no transversion to open or standard laparoscopic approach. The mean operating time,the mean operative time for prostate excision,and the mean time for urethrovesical anastomosis were （ 167 ± 31. 5） min（ ranging 135-210 min） ,（ 115 ± 26） min （ ranging 90-150 min） ,and （ 52 ± 5. 7） min（ ranging 45-60 min） ,respectively. The estimated blood loss averaged （ 90 ± 62） ml （ ranging 50-200 ml）. Positive margin occurred in one case. Transient incontinence occurred in two cases after the catheter was removed one week later. All patients had a prostate-special antigen level 〈 0. 2 μg/L during a follow-up of 4-12 weeks. Conclusion Laparoscopic radical prostatectomy via single incision is feasible and safety. Excellent instruments and skilled surgeon are the keys for the success of the operation.

关 键 词：单切口 前列腺肿瘤 腹腔镜 前列腺根治切除术 

分 类 号：R737.25[医药卫生—肿瘤]