机器人辅助前列腺癌根治术和腹腔镜前列腺癌根治术的回顾性比较  

A retrospective comparison of robotic-assisted laparoscopic prostatectomy versus laparoscopic prostatectomy for the treatment of prostate cancer

作　　者：黄勇[1,2] 罗俊航[1] 莫承强[1] 黄斌[1] 陈炜[1] 王道虎[1] 丘少鹏[1] 吴荣佩[1] 

机构地区：[1]中山大学附属第一医院泌尿外科,广州510080 [2]中山大学附属第一医院急诊科,广州510080

出　　处：《中华腔镜泌尿外科杂志（电子版）》2017年第2期4-8,共5页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的通过对机器人辅助前列腺癌根治术与腹腔镜前列腺根治术的对比研究,探讨机器人外科手术系统在前列腺癌根治术中的优势及不足。方法收集2015年3月至2016年4月收治的前列腺癌患者54例,作为机器人辅助前列腺癌根治术组,2010年1月至2015年1月收治的前列腺癌患者中的50例,作为腹腔镜前列腺癌根治术组。分析比较手术时间、手术出血、围手术期输血率、术后引流量、留置引流管时间、胃肠功能恢复、住院时间、控尿及手术费用等指标。结果两组均成功完成手术,无中转开放性手术。机器人辅助前列腺癌根治术组在尿控方面优于腹腔镜前列腺癌根治术组(P<0.05);在手术出血、围手术期输血率低于腹腔镜前列腺癌根治术组;术后引流量,胃肠道功能恢复及住院时间方面与腹腔镜前列腺癌根治术组差异无统计学意义;在手术时间和手术费用方面多于腹腔镜前列腺癌根治术组。结论机器人辅助前列腺癌根治术术后控尿具有显著优势,术后并发症少,有利于机器人手术辅助系统的推广,但其手术准备时间长,手术费用昂贵是机器人辅助手术发展的瓶颈。Obiective Comparatively analyze the clinical efficacy and safety between robot-assisted radical prostatectomy and laparoscopic radical prostatectomy, aiming to explore the advantages and limitations of robot-assisted surgical system applied in radical prostatectomy. Methods Fifty-four patients diagnosed with prostate cancer admitted to our hospital between March 2015 and April 2016 were recruited and assigned into the robot-assisted radical prostatectomy group. Fifty prostate cancer patients between January 2010 and January 2015 were allocated into the laparoscopic radical prostatectomy group. The operation time, intraoperative hemorrhage volume, perioperative blood transfusion rate, postoperative drainage volume, catheterization time, gastrointestinal functional recovery, length of hospital stay, urinary incontinence and surgical cost were statistically compared between the two groups. Results Surgical procedures were successfully completed in both groups. No patient was switched to open surgery. In the robot-assisted radical prostatectomy group, urinary incontinence was significantly better （P〈0.05）, whereas intraoperative blood loss and perioperative blood transfusion rate were lower compared with those in the laparoscopic radical prostatectomy group. No significant differences were identified regard to postoperative drainage volume, gastrointestinal functional recovery and length of hospital stay between the two groups. In the robot-assisted radical prostatectomy group, operation time was longer and surgical cost was higher than those in the laparoscopic radical prostatectomy group. Conclusion Robot-assisted radical prostatectomy has advantages in terms of urinary incontinence and postoperative complications, which favor the widespread application of robot-assisted surgical system. Nevertheless, the surgical procedures are time consuming and require high surgical cost, which hinder the development of robot-assisted surgery.

关 键 词：机器人 腹腔镜 前列腺癌肿瘤 

分 类 号：R737.25[医药卫生—肿瘤]