改良前列腺尖部分离技术辅助腹腔镜前列腺癌根治术在老年前列腺癌患者中的应用效果  

Application Effect of Modified Prostate Apex Separation Technique-Assisted Laparoscopic Radical Prostatectomy in Elderly Patients With Prostate Cancer

作　　者：王必亮 成艳平 孙士成 王玉明 秦超[3] 赵虎 WANG Bi-liang;CHENG Yan-ping;SUN Shi-cheng;WANG Yu-ming;QIN Chao;ZHAO Hu(Department of Urology,Guanyun Hospital Affiliated to Kangda College,Nanjing Medical University,Guanyun,Jiangsu 222200,China;Department of Radiology,Guanyun Hospital Affiliated to Kangda College,Nanjing Medical University,Guanyun,Jiangsu 222200,China;Department of Urology,People's Hospital of Jiangsu Province,Nanjing 210029,China)

机构地区：[1]南京医科大学康达学院附属灌云医院泌尿外科,江苏灌云222200 [2]南京医科大学康达学院附属灌云医院影像科,江苏灌云222200 [3]江苏省人民医院泌尿外科,南京210029

出　　处：《解放军医药杂志》2022年第8期30-35,共6页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：连云港市卫生科技项目(ZD202009)。

摘　　要：目的探讨改良前列腺尖部分离技术辅助腹腔镜前列腺癌根治术在老年前列腺癌患者中的应用效果。方法选取2018年3月-2021年9月收治的104例老年前列腺癌,按治疗方法的不同分为对照组和研究组,每组52例。对照组采取常规腹腔镜前列腺癌根治术,研究组采取改良前列腺尖部分离技术辅助腹腔镜前列腺癌根治术。比较2组手术情况、肿瘤相关指标[转化生长因子-β1(TGF-β1)、转化生长因子-β3(TGF-β3)、前列腺特异性抗原(PSA)]水平、控尿功能[国际尿失禁咨询委员会尿失禁问卷表(ICIQ-SF)评分、扩展前列腺癌复合指数(EPIC-UIN)、1 h尿垫测定]、性功能[国际勃起功能问卷量表(IIEF-5)评分、国际前列腺症状评分(IPSS)]、尿控率、并发症发生率及生化复发率。结果2组手术时间、术中出血量、住院时间、切缘阳性率比较差异无统计学意义(P>0.05)。研究组尿管留置时间短于对照组(P<0.01)。2组术后1、3个月血清TGF-β1、TGF-β3、PSA低于术前(P<0.05),但2组间比较差异无统计学意义(P>0.05)。2组术后1、3个月ICIQ-SF评分、1 h尿垫测定、IPSS评分低于术前,EPIC-UIN和IIEF-5评分高于术前,且研究组上述指标低于或高于对照组(P<0.05,P<0.01)。研究组术后即刻、术后1、3个月尿控率高于对照组,并发症总发生率低于对照组(P<0.05);2组术后1年生化复发率比较差异无统计学意义(P>0.05)。结论改良前列腺尖部分离技术辅助腹腔镜前列腺癌根治术可显著缩短术后尿管留置时间,促进控尿功能和性功能恢复,减少并发症,且不增加术后生化复发风险。Objective To investigate the application effect of modified prostate apex separation technique-assisted laparoscopic radical prostatectomy in elderly patients with prostate cancer.Methods A total of 104 elderly patients with prostate cancer who were treated from March 2018 to September 2021 were selected and divided into the research group(n=52)and the control group(n=52)according to different treatment methods.The control group received conventional laparoscopic radical prostatectomy,while the research group received modified apex separation technique-assisted laparoscopic radical prostatectomy.The operation conditions,tumor-related indexes[transforming growth factor-β1(TGF-β1),transforming growth factor-β3(TGF-β3),prostate-specific antigen(PSA)]levels before and after operation,urinary continence function[International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF)score,Expanded Prostate Cancer Index Composite(EPIC-UIN),1-h urine pad measurement],sexual function[International Erectile Function Questionnaire(IIEF-5)score,International Prostate Symptom score(IPSS)],urinary continence rate,complication rate and biochemical recurrence rate were compared between the two groups.Results There was no significant difference in duration of operation,intraoperative blood loss,length of hospitalization and positive rate of surgical margin between the two groups(P>0.05).The urinary catheter indwelling time in the research group was shorter than that in the control group(P<0.01).The serum levels of TGF-β1,TGF-β3 and PSA at 1 month and 3 months after operation were lower than those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The ICIQ-SF score,1-hour urine pad measurement,and IPSS score in the two groups were lower than those before surgery,and the EPIC-UIN and IIEF-5 scores were higher than those before surgery;the decrease or increase in above indicators in the research group was greater than that in the control group(P<0.05,P<0.01).The urinary contine

关 键 词：前列腺肿瘤 老年人 改良前列腺尖部分离技术 腹腔镜前列腺癌根治术 控尿功能 性功能 并发症 

分 类 号：R737.25[医药卫生—肿瘤]