机器人辅助腹腔镜后入路根治性前列腺切除术的疗效分析  

The posterior approach of robot-assisted laparoscopic radical prostatectomy

作　　者：夏丹[1] 王平[1] 叶孙益[1] 秦杰[1] 孔德波[1] 景泰乐[1] 来翀[1] 孟宏舟[1] 汪朔[1] 

机构地区：[1]浙江大学医学院附属第一医院泌尿外科,杭州310003

出　　处：《中华泌尿外科杂志》2017年第6期421-423,共3页Chinese Journal of Urology

摘　　要：目的探讨机器人辅助腹腔镜后入路根治性前列腺切除术的可行性及安全性。方法回顾性分析2016年11月至2017年4月收治的32例行机器人辅助腹腔镜后入路根治性前列腺切除术患者的临床资料。年龄53—81岁，平均66．9岁。前列腺体积12．0～73．7ml，平均32．9ml；PSA1．3～24．9ng／ml，平均8．5ng／ml；术前Gleason评分均47分，其中评分6分（Gleason3＋3）者23例，7分者共9例（Gleason3十4者5例，Gleason4＋3者4例；术前TNM分期T1e～T2e期。所有患者均由术前前列腺穿刺活检确诊为前列腺癌，均未接受内分泌治疗。记录手术时间、出血量、住院时间等数据。结果32例手术均顺利完成，无中转开放手术。手术时间129—221min，平均163．6min。出血量20～200ml，平均59．3ml。无严重手术并发症。住院时间8～21d，平均12．8d；术后住院时间3～13d，平均6．9d。术后导尿管留置时间4～14d，平均7．5d。术后随访1—6个月，24例（75％，24／32）获得即时尿控，随访满3个月的26例（100％，26／26）全部获得良好尿控。结论机器人辅助腹腔镜后入路根治性前列腺切除术是一种安全有效的手术方式，有利于术后早期尿控的恢复。Objective To explore the feasibility and safety of the posterior approach of robotassisted laparoscopic radical prostatectomy and to the approach. Methods From November 2001 to April 2017, 32 patients underwent posterior approach of robot-assisted laparoscopic radical prostatectomy. Patients aged 53 to 81 years, with mean of 66.9 years old. Their prostate volumes were 12.0 -73.7 ml with an average of 32.9 ml. All patients were diagnosed by prostate biopsy before surgery. The operation time, blood loss and length of hospital stay were recorded. Results All the operations were completed by robotic assisted laparoscopy with no transition to open surgery. The surgery time was 129 - 210 minutes with an average of 163.6 minutes. The estimated blood loss was 20 - 200 ml with an average of 59.3 ml. The hospital stay was 8 -21 days with an average of 12.8 days. The postoperative hospital stay was 3 -13 days with an average of 6.9 days. The time of postoperative catheter removal was 4 - 14 days with an average of 7.5 days. Postoperative follow-up was 1 -6 months. Twenty-four （75%） patients had early recovery of continence, and all （100%） patients regained continence 3-month postoperatively. Conclusion The posterior approach of robotic assisted laparoscopic radical prostatectomy was a safe and effective surgical technique, which was beneficial in early continence recovery.

关 键 词：前列腺癌 机器人手术 根治性前列腺切除术 后入路 

分 类 号：R737.25[医药卫生—肿瘤]