机器人辅助根治性前列腺切除术治疗大体积局限性前列腺癌的效果分析(附手术视频)  

Clinical efficacy of robot-assisted radical prostatectomy for largevolume localized prostate cancer(with surgical video)

作　　者：尹健 穆一姝 张菲 曹建伟[1] YIN Jian;MU Yishu;ZHANG Fei;CAO Jianwei(Department of Urology,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]陕西省人民医院泌尿外科,陕西西安710068

出　　处：《机器人外科学杂志（中英文）》2024年第4期521-525,共5页Chinese Journal of Robotic Surgery

基　　金：陕西省自然科学基础研究计划项目(2020-JQ-945)。

摘　　要：目的:分析机器人辅助根治性前列腺切除术(RARP)治疗大体积局限性前列腺癌(PCa)的临床效果分析。方法:选取2020年6月—2023年6月陕西省人民医院收治的大体积局限性PCa患者118例,按照随机数表法分为对照组(59例,行常规LRP)和研究组(59例,行RARP),比较两组患者控尿能力、性功能、血清前列腺特异性抗原(PSA)、游离前列腺特异性抗原(f-PSA)、并发症发生率及切缘阳性率。结果:与治疗前比较,两组患者治疗6个月后尿失禁问卷表简表(ICIQ-SF)各维度评分及总分、血清PSA、f-PSA均降低,且与对照组相比,研究组治疗后ICIQ-SF各维度评分及总分、血清PSA、f-PSA更低。与治疗前比较,治疗6个月后两组患者国际勃起功能指数5(IIEF-5)各维度评分及总分降低,与对照组相比,研究组治疗后IIEF-5各维度评分及总分更高。两组患者并发症发生率及切缘阳性率相比,差异无统计学意义。结论:大体积局限性PCa患者开展RARP治疗,可以提高控尿能力,改善性功能,降低血清PSA、f-PSA,且不会增加并发症发生率和切缘阳性率。Objective:To analyze the clinical efficacy of robot-assisted radical prostatectomy(RARP)for large-volume localized prostate cancer(PCa).Methods:118 patients with large-volume localized PCa who were treated in Shaanxi Provincial People’s Hospital from June 2020 to June 2023 were selected.They were randomly divided into the control group(n=59)and the study group(n=59)using a random number table.The control group received conventional laparoscopic radical prostatectomy(LRP),while the study group received RARP.The urinary incontinence,sexual function,serum prostatefree prostate specific antigen(PSA),-specific antigen(f-PSA),complication rate and positive margins of patients in the two groups were compared.Results:The international consultation on incontinence questionnaire short form(ICIQ-SF)scores,serum PSA and f-PSA levels of patients in the two groups were both lowered after 6 months of treatment,and they were lower in the study group than the control group after treatment.The International Index of Erectile Function 5(IIEF-5)scores were lowered in both groups after 6 months of treatment comparing with that before treatment,and the IIEF-5 scores were higher in the study group than the control group after treatment.There was no statistically significant difference in the complication rate and positive margin rate between the two groups.Conclusion:Patients with large-volume localized PCa undergoing RARP can improve urinary incontinence and sexual function,lower serum PSA and f-PSA levels without increasing the complication rate and positive margin rate.

关 键 词：前列腺癌 根治性前列腺切除术 大体积前列腺 机器人辅助手术 肿瘤学结果 性功能 

分 类 号：R737.25[医药卫生—肿瘤]