机器人辅助腹腔镜前列腺癌根治术治疗局部进展期前列腺癌的可行性研究  

Study on the feasibility of robot-assisted laparoscopic radical prostatectomy for locally advanced prostate cancer

作　　者：田雨昌 高飞[1] 王德林[1] 覃云朗 刘恒川 姜文成 张尧[1] 蒲军[1] 何云峰[1] 罗生军[1] 杨磊[1] 吴小候[1] 苟欣[1] TIAN Yuchang;GAO Fei;WANG Delin;QIN Yunlang;LIU Hengchuan;JIANG Wencheng;ZHANG Yao;PU Jun;HE Yunfeng;LUO Shengjun;YANG Lei;WU Xiaohou;GOU Xin(Department of Urology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院泌尿外科

出　　处：《重庆医学》2019年第19期3341-3345,3350,共6页Chongqing medicine

基　　金：重庆市卫生适宜技术推广项目(2018jstg008);重庆市社会事业与民生保障科技创新专项重点研发项目(cstc2017shmszdyfX0022);重庆市基础与前沿研究计划项目(cstc2015jcyjBX0045)

摘　　要：目的比较机器人辅助腹腔镜前列腺癌根治术(RLRP)与普通腹腔镜前列腺癌根治术(LRP)治疗局部进展期前列腺癌患者的临床效果,探讨RLRP治疗局部进展期前列腺癌的安全性和可行性。方法回顾性研究该院2012年2月至2018年5月,37例接受前列腺癌根治术的局部进展期前列腺癌患者的临床资料,其中RLRP组10例,LRP组27例。比较两组患者手术时间、术中出血量、术后住院时间、引流管保留时间、术后切缘阳性率、淋巴结阳性率、术中术后输血、直肠损伤、术后吻合口漏尿等情况。结果37例手术均成功完成,RLRP组、LRP组平均年龄分别为(68.4±6.9)、(66.4±7.7)岁(P>0.05)。两组在手术时间、住院时间、引流管保留时间、输血率、直肠损伤率、术后吻合口漏尿率、淋巴结阳性率、切缘阳性率方面比较,差异无统计学意义(P>0.05)。两组患者术中均无大血管损伤、输尿管口损伤及严重并发症致患者死亡的病例。RLRP组和LRP组术中平均出血量分别为(210.0±99.4)、(382.6±287.6)mL,差异有统计学意义(P<0.05)。结论RLRP治疗局部进展期前列腺癌安全可行,并且在控制术中出血方面优于LRP,但远期疗效有待进一步观察。Objective To investigate the clinical safety and effectiveness of robot-assisted laparoscopic radical prostatectomy(RLRP)for patients with locally advanced prostate cancer(LAPC)compared with laparoscopic radical prostatectomy(LRP).Methods Retrospectively analyzed 37 patients with locally advanced prostate cancer who underwent radical prostatectomy from February 2012 to May 2018,including 10 patients in the RLRP group and 27 patients in the LRP group.The operation time,intraoperative blood loss,postoperative hospital stay,drainage tube retention time,postoperative margin positive rate,lymph node positive rate,intraoperative and postoperative blood transfusion,rectal injury,and postoperative anastomotic leakage were compared.Results All the operations were successfully accomplished.The average age of the RLRP and LRP group was(68.4±6.9)and(66.4±7.7)years old,respectively(P>0.05).There were no significant differences in the operation time,hospitalization time,drainage tube retention time,blood transfusion rate,rectal injury rate,postoperative anastomotic leakage rate,lymph node positive rate and positive margin in the two groups(P>0.05).There were no death cases from large vessel injury,ureteral orifice injury and serious complications.The average bleeding volume in the RLRP and LRP group was(210.0±99.4)and(382.6±287.6)mL respectively,the difference was statistically significant(P<0.05).Conclusion RLRP is safe and feasible for patients with locally advanced prostate cancer,and controlling operation of bleeding is better than LRP,but the long-term efficacy needs further observation.

关 键 词：前列腺肿瘤 机器人手术 腹腔镜 

分 类 号：R737.1[医药卫生—肿瘤]