腹腔镜前列腺癌根治术治疗局限性前列腺癌的效果研究

Clinical effect of laparoscopic radical prostatectomy on localized prostate cancer

目的研究腹腔镜前列腺癌根治术治疗局限性前列腺癌的效果。方法回顾性分析接受手术治疗的86例早期局限性前列腺癌患者的临床资料。根据手术方式不同,分为腹腔镜组(腹腔镜前列腺癌根治术)48例和开腹组(传统的开腹经耻骨后前列腺癌根治术)38例。比较两组患者的手术时间、术中出血量、切缘阳性率、尿管留置时间、术后首次通气时间、术后住院时间、术后并发症的发生情况、手术前后国际前列腺症状评分(IPSS)、术后1年尿控率及生化复发率。结果两组患者的手术时间、尿管留置时间、切缘阳性率比较,差异均无统计学意义(P﹥0.05);腹腔镜组患者的术中出血量明显少于开腹组,术后首次通气时间、术后住院时间均明显短于开腹组,差异均有统计学意义(P﹤0.01)。术后住院期间,腹腔镜组患者的并发症总发生率低于开腹组,差异有统计学意义(P﹤0.05)。腹腔镜组患者术后1个月IPSS明显低于开腹组,差异有统计学意义(P﹤0.01)。两组患者术后1年尿控率、生化复发率比较,差异均无统计学意义(P﹥0.05)。结论与传统的开腹经耻骨后前列腺癌根治术比较,接受腹腔镜前列腺癌根治术治疗的早期局限性前列腺癌患者的术中出血量少、术后恢复快、并发症总发生率低,可有效提高手术安全性,改善患者的前列腺症状,疗效确切,可作为早期局限性前列腺癌患者的首选手术方式。

Objective To research the clinical effect of laparoscopic radical prostatectomy on the treatment of localized prostate cancer.Method The medical records of 86 patients with early-stage localized prostate cancer were retrospectively analyzed.According to different surgical procedures,the patients were divided into laparoscopic group(48 patients underwent laparoscopic radical prostatectomy)and open surgery group(38 patients underwent traditional open retropubic radical prostatectomy).The operation time,intraoperative blood loss,positive surgical margin rate,catheter retention time,postoperative first ventilation time,postoperative hospitalization time,surgical complications,international prostate symptom score(IPSS)before and after surgery,one-year continence rate and one-year biochemical recurrence rate were compared between groups.Result There was no significant difference in the operation time,catheter retention time and positive surgical margin rate between the two groups(P>0.05).The intraoperative blood loss,postoperative first ventilation time and hospitalization time of patients in the laparoscopic group were significantly less than those of patients in the open surgery group(P<0.01).After operations,the total incidence of complications of patients in the laparoscopic group was significantly lower than that of patients in the open group(P<0.05).The IPSS of patients in the laparoscopic group was lower than that of the open surgery group(P<0.01).There was no significant difference in the rates of one-year continence rate and one-year biochemical recurrence rate between the two groups(P>0.05).Conclusion Compared with the traditional retropubic radical prostatectomy,laparoscopic radical prostatectomy for localized prostate cancer can not only improve the safety of surgery with less intraoperative blood loss,lower complication rate and faster postoperative recovery,but also obviously improve the patient’s prostate symptoms with definite efficacy,which could be used as the preferred surgical method for early localized prostate cancer.