开放手术与腹腔镜下前列腺根治术对早期前列腺癌患者的生活质量及尿流动力学影响

The Effects of Open Surgery and Laparoscopic Radical Prostatectomy on Life Quality and Urodynamics in Patients with Early Prostate Cancer

目的探讨开放手术与腹腔镜下前列腺根治术对早期前列腺癌患者的生活质量及尿流动力学影响。方法选择79例早期前列腺癌患者,根据所用手术方法不同,将所有患者分为观察组(39例)及对照组(40例)。对照组患者采用开放性前列腺根治术治疗,观察组采用腹腔镜前列腺根治术治疗。对比2组的围术期指标,2组患者的充盈期膀胱顺应性值、逼尿肌不稳定发生率、最大尿流率、残留尿量值;对比2组的吻合口瘘、切口感染、盆腔感染、膀胱刺激症等并发症。术后1年对比2组患者的尿控率及生化复发率及2组手术前后的国际前列腺症状评分。结果观察组的术中出血量、尿管留置时间及住院时间明显低于(短于)对照组(P<0.05)。观察组的手术时间明显较对照组长(P<0.05)。观察组的充盈期膀胱顺应性值、逼尿肌不稳定发生率、最大尿流率及残留尿量值均明显低于对照组(P<0.05)。观察组的并发症总发生率为5.1%(2/39),低于对照组的22.5%(9/40)(P<0.05)。2组患者的生化复发率、尿控率对比无统计学意义(P>0.05)。术前,2组患者的国际前列腺症状评分差异无统计学意义(P>0.05),术后,观察组的国际前列腺症状评分明显低于对照组(P<0.05)。结论腹腔镜下前列腺根治术可降低对早期前列腺癌患者的创伤,且术后并发症发生率低,可促进尿流动力学的恢复,提高患者生活质量。

Objective To investigate the effects of open surgery and laparoscopic radical prostatectomy on life quality and urodynamics in patients with early prostate cancer.Methods 79 patients with early stage prostate cancer were retrospectively selected,who were divided to the observation group(39 cases)and the control group(40 cases)according to the different surgical methods used.The control group were given open radical prostatectomy,and the observation group were given laparoscopic radical prostatectomy.The perioperative indicators,and the bladder compliance value,detrusor instability rate,the maximum urine flow rate and the residual urine volume,the residual urine volume during the filling period of two groups,the anastomotic leakage,wound infection,and pelvic infection in the two groups complications such as bladder irritation.After surgery for 1 year were compared,and the international prostate symptom score of the 2 groups before and after surgery were compared.Results The intraoperative blood loss amount,catheter indwelling time and hospitalization time in the observation group were significantly lower(shorter)than those in the control group(P<0.05).The operation time of the observation group was longer than that of the control group(P<0.05).The bladder compliance value,detrusor instability rate,maximal urine flow rate and residual urine volume in the filling period in the observation group were significantly lower than those of the control group(P<0.05).The total complication rate was 5.1%(2/39)in the observation group,which was lower than 22.5%(9/40)in the control group(P<0.05).The biochemical recurrence rate and urinary control rate in the 2 groups had no statistically significant(P>0.05).There was no statistically significant difference in international prostate symptom score in the 2 groups preoperatively(P>0.05).After operation,the international prostate symptom score of the observation group were significantly lower than those of the control group after surgery(P<0.05).Conclusion Laparoscopic radical prostatectomy can reduce the trauma of patients with early prostate cancer,and the incidence of postoperative complications and biochemical recurrence is low,which can promote the recovery of urodynamics and improve the quality of life of patients.