保留神经血管束前列腺癌根治术的发展与展望  

Progress and perspective of neurovascular bundle-sparing robot-assisted prostatectomy

作　　者：徐向来 郭剑明 XU Xiang-lai;GUO Jian-ming(Department of Urology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院泌尿外科,上海200032

出　　处：《中国临床医学》2018年第3期321-326,共6页Chinese Journal of Clinical Medicine

基　　金：国家自然科学基金(81772696;81700660)~~

摘　　要：前列腺癌是困扰老年男性的主要健康问题之一。相比其他肿瘤,前列腺癌具有预后佳、生存时间长的特点。而且,前列腺癌根治术不仅需要控制肿瘤发展,也是一个功能重建手术,随之带来较高的术后生活质量要求。据此而提出的前列腺癌手术"三连胜"包括了肿瘤控制、尿控、性功能康复正体现了现代外科"以人为本"的理念。机器人外科手术系统自从问世以来,由于具有微创、3D视野、放大倍数高、机械臂操作稳定灵活、学习曲线较短等优势,越来越多地被应用于辅助腹腔镜根治性前列腺切除术。近年研究显示,其在保留神经血管束方面的优势得天独厚,具有更好的术后尿控及性功能康复。本文就前列腺癌根治术的发展现况进行回顾,并就发展前景作一展望。Prostate cancer is one of the major health problems in elderly men.Compared with other tumors,prostate cancer is characterized by a relatively good prognosis and long survival time.In addition,the goal of radical prostatectomy is not only preventing the recurrence of the tumor,but also reconstructing the urethra.Consequently,it requires higher quality of life after the surgery.A methodology for reporting outcomes after prostate cancer surgery is proposed：＂the so-called trifecta＂,which includes tumor control,urinary continence,and potency recovery.Compared to other surgical procedures,robot-assisted laparoscopic radical prostatectomy has the advantages of minimally invasive treatment,3 Dview,high magnification,stable and flexible robot arms,and a short learning curve.Meanwhile,recent studies have shown that it has the advantage of nerve sparing.This article reviews the current development of radical prostatectomy and looks forward to its future development.

关 键 词：前列腺癌 机器人辅助 根治性前列腺切除术 神经血管束 尿控 性功能 

分 类 号：R737.25[医药卫生—肿瘤]