经腹膜外途径腹腔镜前列腺癌根治术(附12例报告)  

Extraperitoneal laparoscopic radical prostatectomy for 12 cases

作　　者：王琦[1] 袁荫田 王安[1] 潘爱民[2] 高佃军[3] 

机构地区：[1]潍坊医学院,山东潍坊261053 [2]寿光市人民医院泌尿外科 [3]潍坊医学院附属医院泌尿外科

出　　处：《青岛医药卫生》2012年第5期330-332,共3页Qingdao Medical Journal

摘　　要：目的总结分析经腹膜外途径腹腔镜前列腺癌根治术的手术经验及术后疗效。方法回顾性分析我院自2008年4月至2011年11月12例经腹膜外途径腹腔镜前列腺癌根治术患者的临床资料。年龄:64～72岁,平均年龄66.7岁;Gleasnon评分为6～7分;前列腺特异性抗原(PSA):0.7～24.5ng/mL;肿瘤临床分期:T1a～1b2例(17%),T1c4例(33%),T2a～2b4例(33%),T2c2例(17%)。所有患者术前均行前列腺穿刺活检或前列腺电切术后病理证实为前列腺癌。结果 12例患者手术顺利完成,手术时间:160～340min,术中出血:500～1000mL。术后病理均诊断为前列腺癌,切缘阳性1例,其余均为阴性。患者4～6d拔除引流管,14d拔除导尿管。术后1例出现尿漏,9天后消失。3例出现尿失禁,经提肛训练及辅助治疗后恢复。8例患者3个月后阴茎能正常勃起,性生活满意者3例。术后随访3～18月,PSA:0.01～0.08ng/mL。结论经腹膜外腹腔镜前列腺癌根治术具有创伤小、出血少、恢复快的优点,是一种安全有效的手术方式。Objective To investigate the curative effect and the experience of surgical operation of Extraperitoneal Laparoscopic Radical Prostatectomy（ELRP）.Methods Using the reospective method to analyse the clinical data of 12 patients who were performed on using ELRP from April 2008 to November 2011,the age of patients was from 64 to 72 years,the average age was 67.7 years.Gleasnon grade was from 6 to 7,Prostate specific antigen（PSA） level was 0.7-24.5ng/mL,Tumor classification showed T1a-1b tumor in 2 cases（17%）,T1c tumor in 4 cases（33%）,T2a-2b tumor in 4 cases（33%）,T2c tumor in 2 cases（17%）.All patients were pathologic diagnosed with prostate cancer by preoperative prostate biopsy or transurethral resection of prostate surgery.Results The all operations were successful,the time of operation was 160-340 min,the blood loss was 500-1000mL during operation.After operations the pathological replacements were prostatic carcinoma,1 case had positive surgical margin,the rest was negative.Drainage tubes were pulled out on the 4th to 6th day after the operation.Urinary canal was pulled out on 2 weeks after the operation.Urine leak occurred in 1 case,which was recovered without any intervention.The mild urinary incontinence was occurred in 3 cases,which was improved after the training of contacting anus and the aided treatment.Penises of 8 patients can have erection after 3 months,3 patients were able to have sexual intercourse.The time followed was 3-18 months after operation,PSA：0.01-0.08ng/mL.Conclusion ELRP has the feature of little trauma,small bleeding and fast recovery,which is safe and effective for the treatment of prostare cancer.

关 键 词：腹膜外途径 腹腔镜 前列腺癌根治术 

分 类 号：R737.25[医药卫生—肿瘤]