腹腔镜下根治性前列腺切除术疗效分析  

Clinical outcomes after laparoscopic radical prostatectomy

作　　者：高原[1] 韩邦旻[1] 赵炜[1] 阮渊[1] 蒋琪[1] 赵福军[1] 孙晓文[1] 邹青松[1] 姜辰一 蒿魁元 毛师魁 夏术阶[1] 

机构地区：[1]上海交通大学附属第一人民医院泌尿外科,200080

出　　处：《中华泌尿外科杂志》2015年第8期607-610,共4页Chinese Journal of Urology

摘　　要：目的 探讨腹腔镜下根治性前列腺切除术（laparoscopic radical prostatectomy,LRP）的术后疗效.方法 回顾性分析2011年4月至2014年4月行LRP且随访超过1年的176例前列腺癌患者资料.年龄57 ～81岁,平均67岁.术前前列腺特异性抗原2.2～29.3 μg/L,平均8.6 μg/L.记录围手术期数据.术后1、3、6、12个月分别随访患者的PSA水平、尿控情况、性功能恢复情况及并发症发生情况.结果 176例平均手术时间127 min,出血量120 ml,19例切缘阳性,3例淋巴结阳性.出现Clavien Ⅰ级并发症17例（9.7％）,Ⅱ级并发症6例（3.4％）,Ⅲ级并发症4例（2.3％）,未出现Ⅳ、Ⅴ级并发症.术后第6个月出现1例生化复发,术后第12个月3例生化复发.术后1、3、6、12个月完全尿失禁者分别为8例（4.5％）、5例（2.8％）、2例（1.1％）及2例（1.1％）.19例保留性神经病例术后1、3、6、12个月勃起功能恢复者分别为3、5、5、6例.结论 LRP治疗局限性前列腺癌安全、有效,在并发症控制、尿控及性功能恢复等方面有着较明显的优势,肿瘤控制结果同样令人满意.Objective To discuss the postoperative outcomes of prostate cancer patients after laparoscopic radical prostatectomy （LRP）.Methods There were 176 patients who underwent LRP in our center and had a follow-up more than 1 year from April 2011 to April 2014.The clinical data was retrospectively analyzed.The mean age was 67 years （57 to 81 years）.The mean preoperative PSA was 8.6 μg/L （2.2 to 29.3 μg/L）.Results The mean operation time was 127 min,and mean blood loss was 120 ml.Nineteen patients had a positive surgical margin,and 3 patients had positive lymph nodes.There were 17 complications （9.7%） of Clavien Ⅰ,6 （3.4%） of Clavien Ⅱ,4 （2.3%） of Clavien Ⅲ and none of Clavien ⅣW or Ⅴ.One patient got biochemical recurrence after 6 months and 3 after 12 months.Complete urinary incontinence after 1,3,6,12 months was 8（4.5%）,5（2.8%）,2（1.1%） and 2（1.1%） cases.Of the 19 nerve-sparing patients,satisfactory erectile function was gained in 3,5,5 and 6 cases at 1,3,6,12 months postoperatively.Conclusions LRP could be a safe and effective treatment for localized prostate cancer.It is good at the control of complications,urinary continence and erectile function.It is also satisfactory in tumor control.

关 键 词：前列腺肿瘤 根治性前列腺切除术 腹腔镜 治疗结果 

分 类 号：R737.25[医药卫生—肿瘤]