经腹膜外途径腹腔镜前列腺癌根治术10例临床分析

Clinical analysis of 10 patients with prostate cancer treated by extraperitoneal laparoscopic radical prostatectomy

目的：探讨经腹膜外途径腹腔镜前列腺癌根治术治疗前列腺癌的可行性并观察其疗效。方法回顾分析我科2010年10月至2013年9月经腹膜外途径腹腔镜前列腺癌根治术治疗10例前列腺癌患者的临床诊治资料。结果本组10例手术均获得成功，无中转开放手术。手术时间315~495 min，平均（416±62） min，术中出血量150~1500 ml，平均（546±135） ml，3例术后输血4~6 U，6例未输血。术后48 h内胃肠功能恢复，术后3~5 d下床活动，无直肠损伤，1例吻合口尿漏，留置切口引流管8d后漏尿消失。标本切缘阳性3例。3例患者术后半年仍有轻度尿失禁。随访至今，未发现肿瘤局部远处转移；3例患者术后6个月~1年出现生化复发。结论经腹膜外途径腹腔镜前列腺癌根治术是治疗前列腺癌一种安全有效的手术方法，手术创伤小，出血少，并发症少，患者恢复快。

Objective To evaluate the clinical feasibility and efficacy of extraperitoneal laparoscopic radical prostatectomy （ELRP） in the treatment of prostate cancer. Methods The clinical data of 10 patients with prostate can-cer undergoing ELRP from October 2010 to September 2013 in our hospital was retrospectively analyzed. Results All operations were successful without converting to open surgery. The operative time ranged from 315 to 495 min, （416±62） min in mean. The blood loss was 150~1 500 ml, with a mean of （546±135） ml. Three patients received post-operative transfusion of 4~6 U, and 6 patients received no transfusion. The bowel activity was recovered with 48 hours after surgery. All patients were ambulant 3 to 5 days postoperatively. No rectal injury was found. One case of urinary leakage was occurred in this group, and leakage of urine was disappeared after detained suction tube for 8 days, Posi-tive margin was found in 3 patients. Urinary incontinence occurred in 3 cases and improved after supportive treatment. During the following period, three patients showed biochemical recurrence 6~12 months after operation, and no local recurrence or distant metastasis were found. Conclusion ELRP is safe and effective for the treatment of prostate can-cer, with minimal invasion, less bleeding, and rapid recovery.