腹腔镜下前列腺癌根治术临床疗效观察

Effect of laparoscopic radical prostatectomy on the patients with prostate cancer

目的探讨前列腺癌患者腹腔镜下前列腺癌根治术的临床疗效。方法选择2013年5月11日至2015年10月20日新乡医学院第一附属医院收治的88例前列腺癌患者为观察对象,根据手术方式分为腹腔镜组和开放组,每组44例。腹腔镜组患者行腹腔镜下前列腺癌根治术,开放组患者行开放性耻骨后前列腺癌根治术。比较2组患者的手术时间、术中出血量、术后24 h疼痛评分、住院时间、并发症发生率、生化复发率及完全控尿率。结果与开放组比较,腹腔镜组患者手术时间长(P<0.05),术中出血量少(P<0.05),术后24 h疼痛评分低(P<0.05),住院时间短(P<0.05)。开放组和腹腔镜组患者术后并发症发生率分别为31.82%(14/44)和27.27%(12/44),2组患者术后并发症发生率比较差异无统计学意义(χ~2=0.218,P>0.05)。开放组患者术后1、2 a生化复发率分别为11.36%(5/44)和27.27%(12/44),腹腔镜组患者术后1、2 a生化复发率分别为6.82%(3/44)和18.18%(8/44),2组患者术后1、2 a生化复发率比较差异无统计学意义(χ~2=0.550、1.035,P>0.05);开放组患者术后1、2 a完全控尿率分别为45.45%(20/44)和68.18%(30/44),腹腔镜组患者术后1、2 a完全控尿率分别为43.18%(19/44)和65.91%(29/44),2组患者术后1、2 a完全控尿率比较差异无统计学意义(χ~2=0.046、0.051,P>0.05)。结论与开放手术比较,腹腔镜下前列腺癌根治术具有术中出血量少、创伤小、患者住院时间短等优点。

Objective To explore the clinical effect of laparoscopic radical prostatectomy on the patients with prostate cancer.Methods Eighty-eight prostate cancer patients were selected in the First Affiliated Hospital of Xinxiang Medical University from May 2013 to October 2015,and according to the operation method,they were divided into laparoscopy group and open group,with 44 cases in each group.The patients in the laparoscopy group were given application of laparoscopic radical prostatectomy,while the patients in the open group were given application of open pubic radical prostatectomy.Intraoperative time,intraoperative blood loss,pain score at 24 hours after operation,hospitalization time,incidence of postoperative complication,biochemical recurrence rate and total urinary control rate of the two groups were compared.Results Compared with the open group,the operation time of laparoscopy group was longer(P<0.05),intraoperative blood loss was less(P<0.05),pain score at 24 hours after operation was lower(P<0.05),hospitalization time was shorter(P<0.05).The incidence of postoperative complications was 31.82%(14/44)and 27.27%(12/44)in the open group and the laparoscopic group respectively.There was no statistically significant difference in the incidence of postoperative complications between the two groups(χ2=0.218,P>0.05).The biochemical recurrence rate at one year and two years after operation in the open group was 11.36%(5/44)and 27.27%(12/44),while it was 6.82%(3/44)and 18.18%(8/44)in the laparoscopy group;there was no statistically significant difference in the biochemical recurrence rate at one year and two years after operation between the two groups(χ2=0.550,1.035;P>0.05).The total urinary control rate at one year and two years after operation in the open group was 45.45%(20/44)and 68.18%(30/44),and it was 43.18%(19/44)and 65.91%(29/44)in the laparoscopy group;there was no statistically significant difference in the total urinary control rate at one year and two years after operation between the two groups(χ2=0.046,0.051;P>0.05).Conclusion Comparing with the open surgery,laparoscopic radical prostatectomy has the advantage of less intraoperative blood loss,smaller wound for patients and shorter hospitalization time in treating patients with prostate cancer.