经腹与经腹膜外入路对腹腔镜前列腺癌根治术患者的近远期疗效分析

Analysis of the Short-term and Long-term Curative Effect of Transabdominal and Extraperitoneal Approach in Patients Undergoing Laparoscopic Radical Prostatectomy

目的:对比探讨前列腺癌患者行腹腔镜前列腺癌根治术治疗时采取经腹入路与经腹膜外入路对近远期疗效的影响。方法:选择2013年1月—2019年11月靖江市人民医院收治的62例前列腺癌患者为研究对象,根据随机单双号抽签结果分为观察组与对照组,各31例。两组均行腹腔镜前列腺癌根治术,对照组采取经腹入路,观察组实施经腹膜外入路。对比两组手术临床指标,检测对比两组手术前后前列腺功能改善情况,观察统计两组术后并发症总发生率及1年、2年疾病复发率。结果:观察组手术用时、留置尿管时间、住院总时间均明显短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组术后7 d膀胱残余尿量少于对照组,最大尿流率高于对照组,差异有统计学意义(P<0.05)。两组术后并发症总发生率及术后1年、2年疾病复发率比较,差异无统计学意义(P>0.05)。结论:前列腺癌患者行腹腔镜前列腺癌根治术治疗时可首选经腹膜外入路形式,能够有效缩短手术用时及术后恢复时间,减少出血量,改善其前列腺功能,同时降低并发症及复发的概率。

Objective:To compare and explore the impact of transabdominal and extraperitoneal approach on the short-term and long-term efficacy of laparoscopic radical prostatectomy for prostate cancer patients.Method:A total of 62 prostate cancer patients admitted to Jingjiang People's Hospital from January 2013 to November 2019 were selected as the study objects,and randomly divided into observation group and control group based on the results of a single or double number lottery,with 31 patients in each group.Both groups underwent laparoscopic radical prostatectomy,while the control group underwent transabdominal approach and the observation group underwent extraperitoneal approach.The surgical clinical indicators of two groups were compared,the improvement of prostate function before and after surgery were detected and compared,the total incidence of postoperative complications,disease recurrence rate within 1 year and 2 years in both groups were observed and calculated.Result:The surgical time,indwelling catheter time,and total hospitalization time of the observation group were shorter than those of the control group,the intraoperative bleeding of the observation group was less than that of the control group,and the differences were statistically significant(P<0.05).The residual urine volume of the observation group at 7 d after surgery was lower than that of the control group,and the maximum urine flow rate was higher than that of the control group,the differences were statistically significant(P<0.05).There were no statistically significant differences in the total incidence of postoperative complications and disease recurrence rate at 1 year and 2 years after surgery between the two groups(P>0.05).Conclusion:Extraperitoneal approach can be the first choice for laparoscopic radical prostatectomy of prostate cancer patients,which can effectively shorten the surgical time and postoperative recovery time, reduce the amount of blood loss, improve prostate function, and reduce the incidence of complications and recurrence.