3D腹腔镜下行前列腺癌根治术对前列腺癌患者围术期指标及保留勃起功能成功情况的影响

Effects of 3D Laparoscopic Radical Prostatectomy on Perioperative Indicators and Successful Retention of Erectile Function in Patients with Prostate Cancer

目的探讨3D腹腔镜下行前列腺癌根治术(LRP)治疗前列腺癌患者的临床效果。方法选取2019年1月—2023年12月中国人民解放军联勤保障部队第九二四医院收治的119例前列腺癌患者为研究对象,按随机数字表法将其分为对照组(n=58)和观察组(n=61)。对照组采用2D LRP治疗,观察组采用3D LRP治疗。比较两组的围术期指标、尿流动力学指标、应激水平、疼痛程度、保留勃起功能成功情况及并发症发生情况。结果观察组手术出血量少于对照组,手术时间及尿道重建时间均短于对照组,组间差异有统计学意义(P<0.05);两组尿管拔除时间对比,差异无统计学意义(P>0.05)。术后1个月,两组最大尿流率、膀胱残余尿量对比,组间差异无统计学意义(P>0.05)。术后24 h,观察组皮质醇、促肾上腺皮质激素水平均低于对照组,术后6 h、12 h,疼痛视觉模拟评分均低于对照组,组间差异有统计学意义(P<0.05)。观察组保留勃起功能成功率为50.82%,高于对照组的31.03%,并发症发生率为4.92%,低于对照组的17.24%,组间差异有统计学意义(P<0.05)。结论3D LRP治疗前列腺癌效果更佳,可减轻手术应激反应,减少疼痛介质释放,且保留勃起功能成功率高,安全可靠。

Objective To explore the clinical effect of 3D laparoscopic radical prostatectomy(LRP)in the treatment of prostate cancer.Methods A total of 119 patients with prostate cancer admitted to 924th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army from January 2019 to December 2023 were selected as the research objects,and were divided into a control group(n=58)and an observation group(n=61)according to random number table method.The control group was treated with 2D LRP and the observation group was treated with 3D LRP.Perioperative indicators,urodynamics indicators,stress level,pain degree,erectile function retention success and complications were compared between the two groups.Results The amount of surgical bleeding in the observation group was less than that in the control group,and the operative time and urethral reconstruction time were shorter than those in the control group,and the difference between groups was statistically significant(P<0.05);there was no statistical significance in the comparison of urinary tube extraction time between the two groups(P>0.05).1 month after operation,there was no significant difference in maximum urinary flow rate and residual urinary volume between the two groups(P>0.05).24 hours after surgery,the levels of cortisol and adrenocorticotropic hormone in the observation group were lower than those in the control group,6 hours and 12 hours after surgery,the Visual Analogue Scale scores of pain in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).The success rate of erectile function retention in the observation group was 50.82%,which was higher than 31.03%in the control group,and the complication rate was 4.92%,which was lower than 17.24%in the control group,and the differences between the groups were statistically significant(P<0.05).Conclusion 3D LRP is more effective in the treatment of prostate cancer,can reduce the surgical stress response,reduce the release of pain mediators,and retain erectile function with a high success rate,safe and reliable.