腹腔镜下前列腺癌根治术与开放性手术的治疗效果对比分析  

Comparative analysis of laparoscopic radical prostatectomy and open surgery for treatment of prostate cancer

作　　者：刘峰[1] 陈冬[1] 贤少忠[1] 孔广起[1] 孙少鹏[1] 

机构地区：[1]首都医科大学附属北京潞河医院泌尿外科,北京1011000

出　　处：《癌症进展》2016年第3期232-235,共4页Oncology Progress

摘　　要：目的对比分析开放耻骨后前列腺癌根治术与腹腔镜前列腺癌根治术两种不同手术方式围手术期并发症及远期疗效,为治疗方法选择和减少术后并发症提供依据。方法以采用开放耻骨后前列腺癌根治术治疗的47例前列腺癌患者作为对照组,以采用腹腔镜前列腺癌根治术治疗的43例前列腺癌患者作为研究组,观察两组患者的围术期情况、术后PSA值变化及并发症发生状况,2年随访期间术后尿控率和生化复发率。结果两组患者均顺利完成手术。术中指标比较,对照组手术时间低于研究组,术中出血量高于研究组,差异有统计学意义(P﹤0.05);术后指标比较,对照组术后留置导尿管时间、术后肠功能恢复时间、术后疼痛评分及住院时间高于研究组,差异有统计学意义(P﹤0.05),而两组术后通气时间比较,差异无统计学意义(P﹥0.05);对照组术后3个月PSA值为(0.95±0.29)ng/ml,研究组3个月PSA值为(0.87±0.22)ng/ml,两组比较差异无统计学意义(t=1.46,P=0.147);两组患者术后并发症主要为尿失禁、尿漏、切口感染、吻合口狭窄及勃起功能障碍,仅研究组勃起功能障碍发生率(2.33%)低于对照组(14.89%),差异有统计学意义(P﹤0.05);两组其他并发症发生情况比较,差异无统计学意义(P﹥0.05);两组术后一年、术后两年生化复发率及完全控尿率比较,差异无统计学意义(P﹥0.05)。结论腹腔镜前列腺癌根治术具有术中出血量少、损伤小、术后恢复快的优点,且并发症相对开放手术少,是治疗前列腺癌可靠有效的方法。Objective To comparatively analyze the open radical retropubicprostatectomy（open surgery） and the transperitoneal laparoscopic radical prostatectomy （TLRP）, and to investigate theperioperative complications and long term clinical efficacy of the two operative modalities, providing evidence for treatment options and reducing postoperative complications. Method 47 cases treated by open surgery were included as control group, while another 43 cases treated by TLRP were enrolled as study group; The perioperative conditions, postoperative PSA value and complications of the two groups were observed; And all patients were followed up for 2 years to determine the bladder control and the biochemical recurrence. Result Both groups had successfully completed all surgeries; For intraoperativemeasures, the operative time was shorter, while the blood loss was more in control group compared with that of the study group, with significant difference observed （P〈0.05）; Forpostoperative measures, the time for indwelling catheter, intestinal function recovery, pain score and hospital stay were all significantly higher in control group （P〈0.05）, while no difference in postoperative ventilation time was observed （P〉0.05）; the PSA value in 3 months after surgery was similar in both groups at （0.95±0.29） ng/ml in control group and （0.87±0.22） ng/ml in study group, respectively （t=1.46, P=0.147）; The main postoperative complications includedurinary incontinence, urine leaking, surgical incisioninfection, anastomotic stenosis and erectile dysfunction （ED）, and the incidence of urinary incontinence, urine leaking, surgical incision infection and anasto- motic stenosis were similar in the two groups （P〉0.05）, while the incidence of ED was significantly lower in the study group （2.33%） than that of the control group （14.89%）; and the 1-, 2-year postoperative biochemical recurrence rate and complete bladder control were also comparable （P〉0.05）. Conclusion The transperitoneal lap

关 键 词：开放手术 腹腔镜前列腺癌根治术 疗效 

分 类 号：R737.25[医药卫生—肿瘤]