保留Retzius间隙的经腹腔入路与经腹膜外入路对前列腺癌根治术患者围术期指标和术后勃起功能的影响  

Effects of transabdominal approach and extraperitoneal approach with Retzius space preservation on perioperative indicators and postoperative erectile function in patients undergoing laparoscopic radical prostatectomy

作　　者：封志强 张旭 林盛强 陈德敏 黄翔 FENG Zhiqiang;ZHANG Xu;LIN Shengqiang;CHEN Demin;HUANG Xiang(Department of Urology,Fujian Medical University Affiliated Nanping First Hospital,Nanping 353000,Fujian,China)

机构地区：[1]福建医科大学附属南平第一医院泌尿外科,福建南平353000

出　　处：《中国性科学》2024年第2期25-29,共5页Chinese Journal of Human Sexuality

摘　　要：目的探究保留Retzius间隙的经腹腔入路与经腹膜外入路对前列腺癌根治术(LRP)患者围术期指标和术后勃起功能的影响。方法选取2019年4月至2022年8月福建省南平市第一医院收治的62例前列腺癌患者作为研究对象。根据随机数字表法将其分为经腹腔入路腹腔镜前列腺癌根治术(TLRP)组和经腹膜外入路腹腔镜前列腺癌根治术(ELRP)组,各31例。TLRP组行保留Retzius间隙的TLRP治疗,ELRP组行保留Retzius间隙的ELRP治疗,比较两组围术期指标、术后并发症发生情况、术后勃起功能。结果ELRP组手术时间、术中出血量、术后引流时间、术后导尿时间、住院时间均显著低于TLRP组,差异具有统计学意义(P<0.05);两组切缘阳性率比较,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);与术前相比,两组术后3、6个月国际勃起功能指数问卷表-5(IIEF-5)评分均显著降低,差异具有统计学意义(P<0.05);ELRP组术后3、6个月IIEF-5评分均显著高于TLRP组(P<0.05);两组术后6个月勃起功能障碍发生率比较,差异无统计学意义(P>0.05)。结论保留Retzius间隙的ELRP和TLRP均可有效切除前列腺癌病灶,缓解患者病情,并发症发生率相当,但ELRP手术创伤性更小,恢复快,且对术后勃起功能影响更小。Objective To explore the effects of transabdominal approach and extraperitoneal approach with Retzius space preservation on perioperative indicators and postoperative erectile function in patients undergoing laparoscopic radical prostatectomy(LRP).Methods A total of 62 patients with prostate cancer admitted to the First Hospital of Nanping City,Fujian Province from April 2019 to August 2022 were selected as the research subjects.They were divided into transabdominal laparoscopic radical prostatectomy(TLRP)group and extraperitoneal laparoscopic radical prostatectomy(ELRP)group according to the random number table method,with 31 cases in each group.TLRP group received TLRP with Retzius space preservation,and ELRP group received ELRP with Retzius space preservation.Perioperative indicators,postoperative complications,and postoperative erectile function were compared between the two groups.Results The surgical time,intraoperative blood loss,postoperative drainage time,postoperative urinary catheterization time and hospital stay in ELRP group were significantly shorter than those in TLRP group(P<0.05),and there was no statistical difference in the positive rate of incisional margin between the two groups(P>0.05).There were no statistically significant differences in the incidence rates of complications between the two groups(P>0.05).Compared with before surgery,international erectile dysfunction questionnaire-5(IIEF-5)scores in the two groups was both significantly decreased at 3 and 6 months after surgery(P<0.05),and IIEF-5 scores in ELRP group at 3 and 6 months after surgery were significantly higher than those in TLRP group(P<0.05).There was no statistical significance in the incidence rate of erectile dysfunction between the two groups at 6 months after surgery(P>0.05).Conclusions Both ELRP and TLRP with Retzius space preservation can effectively resect the lesions of prostate cancer and alleviate the disease condition,with similar incidence rates of complications.However,ELRP has smaller surgical trauma and faste

关 键 词：前列腺癌 入路方式 勃起功能 

分 类 号：R697[医药卫生—泌尿科学]