单术者前30例机器人与前30例普通腹腔镜前列腺癌根治术的比较  

Radical prostatectomy for prostate cancer: comparison of robotic-assisted versus laparoscopic surgeries

作　　者：马春飞[1] 高旭[1] 王海峰[1] 盛夏[1] 王辉清[1] 鲁欣[1] 王燕[1] 李耀明[1] 方梓宇 施振凯 施挺[1] 孙颖浩[1] 

机构地区：[1]第二军医大学附属长海医院泌尿外科,上海200433

出　　处：《中华腔镜泌尿外科杂志（电子版）》2015年第1期5-9,共5页Chinese Journal of Endourology(Electronic Edition)

基　　金：国家自然科学基金(81172076)

摘　　要：目的通过对单术者前30例机器人辅助的腹腔镜下前列腺癌根治术（RALP）与前30例普通腹腔镜前列腺癌根治术（LP）的对比研究，探讨机器人外科手术系统辅助腹腔镜在根治性前列腺切除术中的优势和应用价值。方法收集2011年11月至2013年7月间，长海医院泌尿外科单术者前30例RALP（A组）与同期该术者前30例LP（B组）手术患者的基线资料、手术时间及术后恢复情况进行对比分析。其中A组前10例，中间10例，后10例分别为A1亚组、A2亚组、A3亚组。B组前10例，中间10例，后10例分别为B1亚组、B2亚组、B3亚组。结果A组与B组患者基线资料之间无统计学差异，各亚组间基线资料未进行统计学差异比较。所有患者均经腹腔途径实施手术，60例手术均获成功，无一例中转开放，术中无直肠、膀胱等脏器副损伤，术后无严重并发症发生。RALP组（A组）患者术中失血量100～900ml，输血1例，术后无尿瘘发生。LP组（B组）术中失血量200～1100ml，输血3例，术后发生尿瘘2例。所有患者均于术后2周拔除导尿管。RALP组中各亚组手术时间分别为：A1亚组124~442min（中位时间280min），A2亚组手术时间118～189min（中位时间164min），A3亚组手术时间105～159min（中位时间128min）；LP组中各亚组手术时间分别为：B1亚组135--402min（中位时间276min），B2亚组125～240min（中位时间206min），B3亚组122～192min（中位时间145min）。结论与传统腹腔镜下前列腺癌根治术相比，机器人辅助的腹腔镜手术视野更加清晰且具有3D视觉，手术操作灵活方便，术者操作更为舒适，学习曲线更短。Objective To evaluate the advantage and application value of robotic-assisted laparoscopic radical prostatectomy by comparing the first 30 robotic-assisted laparoscopic prostatectomy （RALP） with the first 30 laparoscopic prostatectomy （LP） by a single operator. Methods The baseline data, surgical duration and postoperative recovery of the first 30 patients who had undergone RALP （Group A： A 1, A2, A3） and LP （Group B： B 1, B2, B3） by a single operator, respectively, were evaluated and compared from November 2011 to July 2013. Results No significant difference of baseline data was observed between Group A and Group B, and that of different subgroups were not compared. All 60 patients had undertaken the laparoseopic approach, with no halfway alteration to open surgery. No surgical injuries of the rectum or bladder, as well as other severe postoperative complications were recorded. The intraoperative bleeding ofRALP group （Group A） ranged from 100 to 900 ml, with one blood transfusion and no postoperative urinary fistula recorded; as for the LP group （Group B）, intraoperative bleeding ranged from 200 to 1100 ml, with three blood transfusions and two postoperative urinary fistulas recorded. Catheter was removed two weeks postoperatively for all the patients. The surgical duration of RALP group was 124 to 442 minutes （subgroup AI, median： 280 rain）, 118 to 189 minutes （A2, median： 164 min）, and 105 to 159 minutes （A3, median： 128 min）; while that of LP group was 135 to 402 minutes （B1, median： 276 min）, 125 to 240 minutes （B2, median： 206 rain）, and 122 to 192 minutes （B3, median： 145 min）. Conclusion RALP got a three-dimensional vision and clearer surgical field, an enhanced flexibility and versatility, as well as a more delightful user experience and shorter learning curve, compared to conventional LP.

关 键 词：机器人 腹腔镜 前列腺肿瘤 手术 

分 类 号：R737.25[医药卫生—肿瘤]