经腹膜外腹腔镜下前列腺癌改良VIP术治疗早期前列腺癌的临床效果

A preliminary study of modified VIP surgery in extraperitoneal laparoscopic radical prostatectomy for prostate cancer

目的比较经腹膜外行腹腔镜下前列腺癌改良VIP根治术与经腹膜外腹腔镜下前列腺癌常规根治性切除术治疗早期前列腺癌的近期临床疗效。方法选取徐州医科大学附属医院2017年2月至2019年4月收治的早期前列腺癌患者60例,其中30例经腹膜外行腹腔镜下前列腺癌常规根治性切除术(常规组),30例经腹膜外行腹腔镜下前列腺癌改良VIP根治术(改良组)。比较两组患者的围手术期指标及术后尿控、性功能恢复情况,并观察术后并发症发生情况。结果两组患者手术均获得成功。改良组的手术时间少于常规组[(119.0±22.6)min vs.(159.7±44.4)min],改良组的住院时间少于常规组[(9.0±3.4)d vs.(13.9±6.6)d],差异有统计学意义(P<0.05)。改良组患者术后即刻和术后3个月的尿控满意率分别为66.7%、86.7%,高于常规组的20.0%、33.3%,差异有统计学意义(P<0.05);改良组患者术后3、6个月的性功能正常率分别为60.0%、80.0%,优于常规组的23.1%、38.5%,差异有统计学意义(P<0.05)。结论对于术前尿控、性功能正常的T1~T2期局限性前列腺癌,经腹膜外行腹腔镜下前列腺癌改良VIP术是一种安全、有效的手术方式,值得临床推广应用。

Objective To investigate the short-term efficacy of extraperitoneal laparoscopic radical prostatectomy with modified VIP and extraperitoneal conventional radical prostatectomy.Methods A retro-spective analysis of 60 patients with extraperitoneal laparoscopic radical prostatectomy who were treated by the same group from February 2017 to April 2019 in our hospital was performed.Among them,30 patients underwent laparoscopic modified VIP(modified group)and 30 underwent laparoscopic conventional radical prostatectomy(conventional group).The perioperative indexes,postoperative urinary control function and erectile function assessment results were compared between the two groups and the occurrence of postoperative complications were observed.Results Surgery was successful in both groups.The operation time of the modified group was shorter than that of the conventional group([119.0±22.6]min vs.[159.7±44.4]min],and the hospitalization time of the modified group was shorter than that of the conventional group([9.0±3.4)d vs.[13.9±6.6]d),The difference was statistically significant.The satisfaction rate of urinary control in patients in the modified group was 66.7%and 86.7%immediately after surgery and 3 months after operation,which were higher than those in the conventional group(20.0%and 33.3%).The difference was statistically significant(P<0.05);The normal rates of sexual function at 3 and 6 months after operation were 60.0%and 80.0%,respectively,which were better than the 23.1%and 38.5%of the conventional group,and the difference was statistically significant(P<0.05).Conclusions For the early-stage localized prostate cancer of T1 to T2 stage with urinary control and normal sexual function before surgery,the laparoscopic prostatectomy with modified VIP for prostate cancer is a safe and effective surgical method,which is worthy of clinical application.