经腹膜外入路腹腔镜根治术治疗前列腺癌的效果及对控尿功能的影响

Therapeutic effect of extraperitoneal laparoscopic radical prostatectomy on prostatic carcinoma and its impact on urinary control function

目的探讨经腹膜外入路腹腔镜根治术(ELRP)对前列腺癌的治疗效果及其对控尿功能的影响。方法前瞻性随机对照研究。抽取2021年3月至2022年3月南阳市中心医院泌尿外科收治的前列腺癌患者84例,根据随机信封法分为对照组和观察组,每组42例。对照组患者采取经腹入路腹腔镜根治术(TLRP)治疗,观察组患者采取ELRP治疗,观察并比较两组围术期各指标、术后不同时点患者控尿功能情况以及术后并发症发生情况。结果观察组手术时长、导尿管留置、术后住院时间以及术后出血量各指标改善情况均优于对照组(P均<0.05);两组胃肠道恢复时间比较差异未见统计学意义(P>0.05)。术后1、6个月,观察组控尿正常占比高于对照组(P<0.05);术后1年,两组控尿正常占比比较差异未见统计学意义(P>0.05)。两组术后并发症发生率比较差异未见统计学意义(P>0.05)。结论相较于TLRP,ELRP治疗前列腺癌患者的早期疗效较佳,可有效提高手术效率,减少术中出血量,且术后控尿功能恢复好。

Objective To investigate the effect of extraperitoneal laparoscopic radical prostatectomy(ELRP)in the treatment of prostatic carcinoma and its influence on urinary control function.Methods This study was a prospective randomized controlled trail.Eighty-four patients with prostatic carcinoma admitted to Department of Urology in Nanyang Central Hospital from March 2021 to March 2022 were selected as the study subjects.According to the random envelope method,they were divided into the control group and the observation group,with 42 cases in each group.The patients in the control group were treated by transabdominal laparoscopic radical prostatectomy(TLRP),and the patients in the observation group were treated by ELRP.The perioperative indexes,urinary control function at different time points after operation and incidence of postoperative complications of the two groups were observed and compared.Results The observation group showed better improvement in various indicators such as duration of surgery,time of catheters retention,postoperative hospital stay,and postoperative bleeding compared with the control group(all P<0.05).However,there was no significant difference in the recovery time of the gastrointestinal tract between the two groups(P>0.05).The proportion of normal urinary control in the observation group was significantly higher than that in the control group 1 and 6 months after surgery(P<0.05).There was no significant difference in urinary control function between the two groups after 1 year of surgery(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions Compared with TLRP,ELRP has better efficacy in the early treatment of prostatic carcinoma,which can effectively improve the operation efficiency,reduce intraoperative bleeding,and restore postoperative urinary control function better.