腹腔镜前列腺癌根治术(附八例报告)

Laparoscopic radical prostatectomy (report of 8 cases)

目的 总结腹腔镜前列腺癌根治术的体会。 方法 8例均为pT1b～pT2 期前列腺癌患者。腹腔镜下采用“5孔 7步法” ,经腹分别行膀胱后入路和前入路分离前列腺、切开膀胱颈、前列腺两侧分离、前列腺尖部切除、膀胱尿道吻合。 结果 8例患者手术时间 5～ 11h ,平均 7.3h。出血量 2 0 0～ 110 0ml,平均 62 0ml。术后患者恢复良好 ,3周后拔除尿管排尿通畅 ,随访 3～ 18个月无尿失禁等并发症发生。 结论 腹腔镜前列腺癌根治术有良好的解剖影像 ,利于术中操作 ,减少术中出血 ,更好地保护重要解剖结构 。

Objective To evaluate laparoscopic radical prostatectomy for prostate cancer. Methods 8 patients presented clinical stages pT 1b to pT 2 prostate cancer.Laparoscopic radical prostatecomy was carried out transperitoneally with combining posterior and anterior approachs to the prostate,transecting the bladder neck,lateral dissection of the prostate and urethrovesical anastomosis. Results The operation time was 5 to 11 h with an average of 7.3 h and the blood loss 200 to 1 100 ml,averaged 620 ml.All the patients recovered well and uneventful with no complications such as urethral stricture or incontinence. Conclusions Laparoscopic radical prostatectomy is a better approach and least invasive.The procedure provides clear anatomic vision that facilitates operative performance and quicker recovery.