经腹膜外途径腹腔镜手术治疗前列腺癌的临床疗效观察  

Observation on the Clinical Efficacy of Via Extraperitoneal Approach in Laparoscopic Surgery in Treatment of Prostate Cancer

作　　者：叶韬[1] 李成文[1] 高加胜[1] 张海峰 李志坚[1] YE Tao;LI Chengwen;GAO Jiasheng;ZHANG Haifeng;LI Zhijian(Jiujiang First People’s Hospital,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院

出　　处：《中国医学创新》2019年第36期54-57,共4页Medical Innovation of China

基　　金：九江市科技计划项目（2017101）

摘　　要：目的:探讨经腹膜外途径腹腔镜手术治疗前列腺癌的临床疗效。方法:选择2015年6月-2019年6月就诊本院的前列腺癌患者72例,按治疗方式不同分为试验组和对照组,各36例。两组均在全麻下行腹腔镜手术治疗,对照组手术经腹腔途径实施,试验组手术经腹膜外途径实施。比较两组围术期相关指标、生活质量评分、拔管时和术后3个月时正常控尿率及术中、术后并发症发生情况。结果:试验组手术用时、住院时间、术中失血量、术后肛门排气时间、导尿管留置时间均短于对照组,差异均有统计学意义(P<0.05);术后,两组生活质量评分均高于术前,且试验组生活质量评分高于对照组,差异均有统计学意义(P<0.05);两组拔管时和术后3个月时正常控尿率比较,差异均无统计学意义(P>0.05);两组术中、术后并发症发生率比较,差异均无统计学意义(P>0.05)。结论:经腹腔、经腹膜外途径腹腔镜手术治疗前列腺癌安全性、控尿效果相当,但后者对机体造成的创伤较小,可缩短术后恢复时间,利于提高生活质量。Objective:To explore the clinical effect of via extraperitoneal approach in laparoscopic surgery in treatment of prostate cancer.Method:A total of 72 patients with prostate cancer in our hospital from June 2015 to June 2019 were selected.According to the different treatment,the patients were divided into the experimental group and the control group,36 cases in each group.Laparoscopic surgery was performed under general anesthesia in both groups.The operation in the control group was performed by abdominal approach,and the operation in the experimental group was performed by extraperitoneal approach.The related indexes of perioperative period,quality of life score,normal urinary control rate at extubation and 3 months after operation,and the occurrence of complications during and after operation between two groups were compared.Result:The operation time,hospitalization time,blood loss during operation,anal exhaust time and catheter indwelling time in the experimental group were less than those in the control group(P<0.05).After operation,the quality of life scores of the two groups were higher than those of before operation,and the quality of life score of the experimental group was higher than that of the control group,the differences were statistically significant(P<0.05).There were no significant differences between the two groups in the rate of normal urine control at extubation and 3 months after the operation(P>0.05).There were no significant differences in the incidence of intraoperative and postoperative complications between the two groups(P>0.05).Conclusion:Laparoscopic surgery via peritoneal and extraperitoneal approaches for prostate cancer is quite safe and effective in urine control,but the latter causes less trauma to the body,which can shorten the postoperative recovery time and improve the quality of life.

关 键 词：前列腺癌 腹腔镜手术 经腹膜外途径 控尿效果 

分 类 号：R737.25[医药卫生—肿瘤]