机器人辅助腹腔镜与标准腹腔镜治疗局限性前列腺癌的疗效对比  

Comparison of Surgical Cure Effect of Da Vinci Robot-assisted and Standard Laparoscopic Radical Prostatectomy in Patients With Localized Prostate Cancer

作　　者：强济斌 黄晓菲 吴志强[1] 张庆卫[1] 陈鑫[1] QIANG Jibin;HUANG Xiaofei;WU Zhiqiang;ZHANG Qingwei;CHEN Xin(Department of Urology Surgery,Chifeng Municipal Hospital,Chifeng Inner Mongolia 024000,China;Department of Operating Room,Chifeng Municipal Hospital,Chifeng Inner Mongolia 024000,China)

机构地区：[1]赤峰市医院泌尿外科,内蒙古赤峰024000 [2]赤峰市医院手术室,内蒙古赤峰024000

出　　处：《中国卫生标准管理》2022年第2期39-43,共5页China Health Standard Management

摘　　要：目的对比机器人辅助腹腔镜与标准腹腔镜治疗在局限性前列腺癌的疗效,旨在为前列腺癌患者手术治疗方案提供参考依据。方法回顾性分析我院2016年10月—2019年12月收治的328例局限性前列腺癌患者,其中腹腔镜组(n=176)行标准腹腔镜根治性前列腺切除术,机器人组(n=152)行机器人根治性前列腺切除术。比较两组患者资料,包含术前一般资料、术中出血量、手术时间、膀胱颈尿道吻合时间,术后进食时间、盆腔引流管拔除时间、尿管拔除时间、住院时间、住院总费用及术后随访尿控和性功能恢复情况。结果机器人组术中手术时间、术中出血量及尿道膀胱颈吻合时间均优于腹腔镜组,差异有统计学意义(P<0.05);机器人组术后住院天数、留置尿管时间明显短于腹腔镜组,差异有统计学意义(P<0.05);机器人组术后进食时间晚于腹腔镜组,住院总费用明显高于腹腔镜组,差异有统计学意义(P<0.05);两组盆腔引流管拔出时间对比,差异无统计学意义(P>0.05);机器人组即刻尿控、术后1、3个月尿控率均高于腹腔镜组,差异有统计学意义(P<0.05),两组术后6、12个月尿控率比较,差异无统计学意义(P>0.05);两组术后3、6、12个月的IIEF-5评分比较,差异无统计学意义(P>0.05)。结论与标准腹腔镜根治性前列腺切除术比较,机器人根治性前列腺切除术具有手术时间短、术中出血量少、术后住院时间短、术后早期尿控恢复情况好等明显优势,机器人对局限性前列腺癌的治疗在临床上可达到较为满意的疗效,但住院费用较高,这是限制其在我国开展的主要原因。Objective To compare surgical cure effect for localized prostate cancer between Da Vinci robot-assisted laparoscopic radical prostatectomy(RARP)and standard laparoscopic radical prostatectomy(LSRP),the purpose is to provide reference for surgical treatment of patients with localized prostate cancer.Methods A total of 328 patients with localized prostate cancer treated in our hospital from October 2016 to December 2019 were analyzed retrospectively.The laparoscopic group(n=176)underwent LSRP and the robot group(n=152)underwent RARP,The data of the two groups were compared,including preoperative general data,intraoperative bleeding,operation time,bladder neck urethral anastomosis time,postoperative eating time,pelvic drainage tube removal time,urinary tube removal time,hospitalization time,hospitalization expenses,postoperative follow-up urinary control and sexual function recovery.Results The intraoperative operation time,intraoperative bleeding and urethral bladder neck anastomosis time in the robot group were better than those in the laparoscopy group,with differences were statistically significant(P<0.05);the postoperative hospitalization days and indwelling catheter time in the robot group were significantly shorter than those in the laparoscopy group,with differences were statistically significant(P<0.05);the postoperative eating time in the robot group was later than that in the laparoscopy group,and the total hospitalization cost was significantly higher than that in the laparoscopy group,with differences were statistically significant(P<0.05);there was no significant difference in the time of pelvic drainage tube extraction between the two groups(P>0.05);the immediate urinary control and the urinary control rate at 1 and 3 months after operation in the robot group were significantly higher than those in the laparoscopy group,with differences were statistically significant(P<0.05).There was no significant difference in the urinary control rate at 6 and 12 months after operation between the two groups(P>0.05

关 键 词：机器人 腹腔镜 前列腺癌 根治性前列腺切除 疗效对比 术后尿控 手术方式 

分 类 号：R737[医药卫生—肿瘤]