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新辅助内分泌治疗后机器人辅助与传统腹腔镜前列腺癌根治术围术期疗效比较 被引量:2

Comparison of the perioperative outcome of robotic-assisted laparoscopic and laparoscopic radical prostatectomy after neoadjuvant hormonal therapy
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摘要 目的:比较新辅助内分泌治疗后的腹腔镜前列腺癌根治术(LRP)与机器人辅助腹腔镜前列腺癌根治术(RARP)的围术期疗效,探讨新辅助内分泌治疗对两种术式的影响。方法:回顾性分析2019年1月-2021年12月本中心收治的新辅助内分泌治疗后行前列腺癌根治术的患者128例,其中69例行腹腔镜手术,59例行机器人辅助腹腔镜手术。总结患者的临床病理资料,包括年龄、新辅助内分泌治疗用药时间、前列腺特异性抗原(PSA)、Gleason评分等。采用Mann-Whitney U检验比较两种手术方式的手术时间、术后引流量及术后住院时间等。使用累积和(CUSUM)法绘制RARP的学习曲线。结果:两种术式的术中出血量、术中输血、术后引流量差异无统计学意义(P>0.05)。RARP手术时间和术后住院时间长于LRP(P<0.05);但RARP手术例数增加至学习曲线拐点后(40例),两种术式的手术时间和术后住院时间差异无统计学意义(P>0.05)。RARP学习曲线在手术例数累积时达到最高点,40例后曲线平稳下降。结论:对于熟练术者,新辅助内分泌治疗后RARP和LRP在手术时间、术中出血量、术后住院时间等方面无显著差异;RARP的学习曲线未受到新辅助内分泌治疗影响。 Objective:To compare the perioperative efficacy of laparoscopic radical prostatectomy(LRP)and robot-assisted laparoscopic radical prostatectomy(RARP)after neoadjuvant hormonal therapy,and to explore the influence of neoadjuvant hormonal therapy on the two surgical modes.Methods:A retrospective analysis was conductedfrom January 2019 to December 2021 on 128 patients undergoing radical prostatectomy after neoadjuvant hormonal therapy treated by the Center,of which 69 cases underwent laparoscopic surgery and 59 cases underwent robotic-assisted laparoscopic surgery.The patient’s clinical pathological data,including age,time of neoadjuvant hormonal therapy,prostate-specific antigen(PSA),Gleason score,etc.,were summarized.The Mann-Whitney U test was used to compare the operation time,postoperative drainage and postoperative hospital stay of the two surgical methods.The learning curve of robotic surgery was plottedby the CUSUM analysis method.Results:There were no significant differences in intraoperative bleeding,intraoperative blood transfusion and postoperative drainage between the two surgical modes(P>0.05).The operation time and postoperative hospital stay of RARP were longer than those of LRP(P<0.05).After the number of RARP operations increased to the inflection point of the learning curve(skilled operators),there was no significant difference in operation time and postoperative hospital stay between the two methods(P>0.05).The learning curve of RARP reached the highest point when the number of surgical cases accumulated in 40 cases,and the curve decreased steadily after 40 cases.Conclusion:For skilled surgeons,there is no significant difference between RARP and LRP in operation time,intraoperative bleeding and postoperative hospital stay after neoadjuvant hormonal therapy.The learning curve of RARP is not affected by neoadjuvant hormonal therapy.
作者 韩文聪 吴永吉 孙旭东 王宇 孟一森 张崔健 蔡林 谌诚 张争 李学松 张骞 张凯 龚侃 何志嵩 周利群 Han Wencong;Wu Yongji;Sun Xudong;Wang Yu;Meng Yisen;Zhang Cuijian;Cai Lin;Shen Cheng;Zhang Zheng;Li Xuesong;Zhang Qian;Zhang Kai;Gong Kan;He Zhisong;Zhou Liquan(Department of Urology,Peking University First Hospital,Institute of Urology,Peking University,National Urological Cancer Center,Beijing 100034,China;Department of Urology,Zhengzhou Ninth People’s Hospital,Zhengzhou 450000;Department of Urology,Peking University First Hospital,Xinxiang Central Hospital,Xinxiang 453000)
出处 《微创泌尿外科杂志》 2022年第2期81-86,共6页 Journal of Minimally Invasive Urology
关键词 腹腔镜前列腺癌根治术 机器人辅助腹腔镜前列腺癌根治术 新辅助内分泌治疗 学习曲线 laparoscopic radical prostatectomy robot-assisted laparoscopic radical prostatectomy neoadjuvant hormonal therapy learning curve
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