开放前列腺癌根治术与腹腔镜前列腺癌根治术临床的疗效比较

Comparison of open radical prostatectomy versus laparoscopic radical prostatectomy in the treatment of prostate cancer

目的回顾性分析开放前列腺癌根治术(ORP)与腹腔镜下前列腺癌根治术(LRP)的临床疗效,探讨两种不同术式疗效的差异。方法收集2013年3月至2018年9月在本院收治的52例行前列腺癌根治术患者的临床资料,按手术方式分为ORP组和LRP组,其中ORP组21例,LRP组31例。分析比较两组围手术期指标、手术并发症和术后功能方面的差异。结果两组手术操作时间、术中出血量、输血率、膀胱颈尿道吻合口狭窄发生率、术后下床活动.时间、术后住院时间、手术花费比较,差异具有统计学意义(P<0.05)。两组切口感染、尿漏、标本切缘阳性率清扫淋巴结数目、淋巴结阳性检出率、引流管拔除时间、尿管拔除时间、即刻尿控率、术后6个月尿失禁发生率方面比较,差异无统计学意义(P>0.05)。结论LRP具有创伤小、出血少、术后恢复快的优点,而且在临床疗效以及并发症方面与ORP相近。对于有条件的基层医院而言,LRP是一种安全、可行有效的手术方式,值得基层医院泌尿外科医师开展。

Objective To retrospectively analyze the clinical ffcacy of open radical prostatectomy(ORP)and laparoscopic radical prostatectomy (RP)for prostate cancer,and to explore the difference between the two methods.Methods The clinical data of 52 patients underwent radical prostatectomy(RP)in our hospital from March 2013 to September 2018 were collected.They were divided into ORP group and LRP group according to the operation methods,including 21 cases in ORP group and 31 cases in LRP group.The differences of perioperative indicators,operative complications and postoperative function between the two groups were analyzed and compared.Results There were significant differences in operation time,intraoperative bleeding,blood transfusion rate,time of getting out of bed after operation,hospital stay after operation and operation cost between the two groups.There were no significant differences in incision infection,urinary leakage,positive rate of incision margin,mumber of lymph nodes cleared,positive detection rate of lymph nodes,time of drainage tube removal,time of catheter removal,incidence of bladder neck-urethral anastomotic stricture,incidence of immediate urinary control and urinary incontinence 6 months after operation between the two groups.Conclusions LRP has the advantages of less trauma,less bleeding and quick recovery after operation.It is similar to ORP in terms of function,oncology and complications.LRP is a safe,feasible and effective surgical method for qualified grassroots hospitals.It is worth developing by urologists in grass-roots hospitals.