腹腔镜前列腺癌根治术患者术后并发症及疗效观察

Postoperative complications and efficacy of laparoscopic radical prostatectomy

目的探讨腹腔镜前列腺癌根治术患者术后并发症及疗效。方法选取2013年1月至2015年11月间辽宁省葫芦岛市中心医院收治的行前列腺癌根治术的80例前列腺癌患者,采用随机数表法分为观察组与对照组,每组40例,观察组患者采用腹腔镜前列腺癌根治术,对照组患者采用开放式前列腺癌根治术。比较两组患者术中出血量、尿管拔除时间、住院时间、术后并发症和1年内的生化复发率及完全控尿率。结果观察组患者术中出血量、尿管拔除时间和住院时间分别为(762.5±125.3)ml、(14.2±3.7)d和(15.3±4.7)d,均低于对照组患者的(1346.7±164.2)ml、(19.2±4.3)d和(23.4±6.1)d,差异均有统计学意义(均P<0.05)。观察组患者并发症发生率为15.0%,分别为吻合口狭窄1例、尿漏2例和勃起功能障碍3例,对照组患者的并发症发生率为35.0%,分别为吻合口狭窄3例、尿漏5例和勃起功能障碍6例,两组组间比较,差异有统计学意义(P<0.05)。观察组患者生化复发率为2.5%低于对照组患者的15.0%,观察组患者完全控尿率为72.5%高于对照组患者的52.5%,两组组间比较,差异均有统计学意义(均P<0.05)。结论腹腔镜前列腺癌根治术能够明显降低患者术后并发症发生率,有利于患者术后康复。

Objective To study the postoperative complications and efficacy of laparoscopic radical prostatectomy.Method A total of 80 patients undergoing laparoscopic radical prostatectomy at Huludao Central Hospital from January 2013 to November 2015 were selected.Using a random number table,patients were randomized into an observation group and a control group with 40 patients in each group.Patients in the observation group underwent laparoscopic radical prostatectomy and patients in the control group underwent open radical prostatectomy.The intraoperative bleeding,time to extubation,length of hospitalization,incidence of complications,1-year biochemical relapse rate and complete continence rate were compared between the two groups.Results The intraoperative bleeding,time to extubation and length of hospitalization was（762.5±125.3） ml,（14.2±3.7） d and（15.3±4.7） d for the observation group,respectively which was significantly lower than（1346.7±164.2） ml,（19.2±4.3） d and（23.4±6.1） d of the control group（P0.05）.The incidence of complications was 15.0% for the observation group including anastomotic stricture in 1 patient,urinary leakage in 2 patients and erectile dysfunction in 3 patients;the incidence of complications was 35.0% for the control group including anastomotic stricture in 3 patients,urinary leakage in 5 patients and erectile dysfunction in 6 patients（P0.05）.The biochemical relapse rate was2.5% for the observation group which was significantly lower than 15.0% of the control group（P0.05）.The complete continence rate was 72.5% for the observation group which was significantly higher than 52.5% of the control group（P0.05）.Conclusion Laparoscopic radical prostatectomy can significantly reduce the incidence of postoperative complications and is conducive to the rapid recovery and rehabilitation.