改良腹腔镜前列腺癌根治术在预防术后腹股沟疝的临床研究

Reseach of improved laparoscopic radical prostatectomy for prevention of postoperative inguinal hernia occurrence

目的:研究改良腹腔镜前列腺癌根治术(LRP)对术后预防腹股沟疝发生的临床意义。方法:回顾性分析我院2016年1月~2017年2月78例行LRP患者的临床资料。其中44例行改良LRP(治疗组),34例行未改良LRP(对照组)。两组患者术前年龄、BMI、前列腺体积、PSA、既往腹部手术史比较差异均无统计学意义(P>0.05)。比较两组患者术后1、3、6、9、12个月的腹股沟疝发生情况,并采用Cox回归模型分析腹腔镜前列腺癌术后腹股沟疝发生的危险因素。结果:对照组术后疝发生7例(20.59%),治疗组术后疝发生1例(2.27%)。改良手术方式是术后疝发生的重要影响因素。Kaplan-Meier生存曲线显示改良手术方式很大程度上降低了术后疝的发生率(P<0.05)。结论:行改良LRP可降低术后腹股沟疝的发生率,临床疗效满意。

Objective：To study the significance of improved laparoscopic radical prostatectomy（LRP）for prevention of postoperative inguinal hernia（IH）occurrence.Method：The 78 cases between January 2016 and February 2017 in our hospital were completed laparoscopic prostate cancer radical resection.The clinical data were retrospectively analyzed.Forty-four cases undergoing improved LRP were recorded as treatment group,and other 34 cases undergoing laparoscopic radical resection of non-improved were denoted as the controls.Preoperative data of two groups including patients＇ age,mean BMI,prostate volume,PSA,surgical operation history showed no statistical difference（P0.05）.Postoperative data including 1,3,6,9,12 months of IH occurrence between two groups were set for Cox proportional hazard regression model to find out the factors which affect the postoperative IH occurrence.Result：Seven patients（20.59%）appeared postoperative IH in control group,while one case（2.27%）occurred in treatment group.The improved LRP was correlated independently with postoperative IH occurrence.Kaplan-Meier survival curve showed improved LRP largely reduced the incidence of postoperative IH（P0.05）.Conclusion：Improved LRP is favourable to reduce incidence of postoperative IH.