经腹膜外途径腹腔镜前列腺癌根治术15例临床分析

Clinical analysis of 15 cases of extraperitoneal laparoscopic radical prostatectomy

目的探讨经腹膜外途径腹腔镜前列腺癌根治术的手术方法和疗效。方法回顾性分析我院15例前列腺癌患者行经腹膜外途径腹腔镜前列腺癌根治术的临床资料。15例患者病理诊断均为前列腺癌，其中T1N0M0 7例，T2N0M08例，Gleason评分均≤7分。结果15例手术均获得成功，无中转开放手术。手术时间110～300min，平均160min；术中出血量180～800ml，平均300ml。术后72h内胃肠功能恢复。术后保留导尿2～3周，3个月后无真性尿失禁发生。术后病理报告示标本切缘阳性1例。术后复查血前列腺特异性抗原（PSA）除1例切缘阳性患者为3．20μg／L外，其余均小于0．1μg／L。结论经腹膜外腹腔镜前列腺癌根治术是一种安全有效的手术方法，手术创伤小，患者恢复快，腹腔并发症少，值得在临床推广应用。

Objective To evaluate the surgical technique and clinical efficacy of extraperitoneal laparoscopic radical prostateetomy for prostate cancer. Method 15 patients with localized prostate cancer treated with extraperitoneal laparo- scopic radical prostatectomy were analyzed retrospectively. All of the patients were diagnosed as prostate cancer with G1- eason sore≤7 by pathological biopsy. There were 7 cases of T1No M0 and 8 cases of T2 N0M0. Results All operations were successful without converting to open laparotomy. The operative time ranged from 110 -300 min （mean： 160 min）, the intraoperative blood loss was 180 -800 ml（ mean： 300 ml）. The bowel activity was recovered within 72 h after surgery. Urinary catheter was kept for 2 - 3 weeks and no genuine urinary incontinent was observed after 3 months. Positive surgical margin was found in one case. Postoperative serum prostate - specific antigen （PSA） level was less than 0.1μg/ L in all the patients except that one patient with positive margin was 3.20 μg/L. Conclusion Extraperitoneal laparo- scopic radical prostatectomy is a safe and effective surgical procedure with minimal invasion, fewer complications and rap- id recovery, and is worthy of being extended in clinical application.