实用肿瘤学杂志 ›› 2010, Vol. 24 ›› Issue (6): 533-535.doi: 10.3969/j.issn.1002-3070.2010.06.008

• 论著 • 上一篇    下一篇

腹腔镜前列腺癌根治术经腹腔与经腹膜外途径的效果比较

王志荣, 胡强, 徐卓群, 王强, 邵剑锋, 严志强, 宣枫, 黄兴, 周洪益   

  1. 南京医科大学附属无锡人民医院泌尿外科(无锡 214023)
  • 收稿日期:2010-09-03 出版日期:2010-12-28 发布日期:2015-01-24
  • 通讯作者: 王志荣,E-mail:wzr211@163.com
  • 作者简介:王志荣,男,(1968-),本科,副主任医师,从事泌尿外科微创手术及泌尿系肿瘤研究

Laparoscopic radical prostatectomy:transperitoneal approach versus extraperitoneal approach

WANG Zhirong, HU Qiang, XU Zhuoqun, WANG Qiang, SHAO Jianfeng, YAN Zhiqiang, XUAN Feng, HUANG Xing, ZHOU Hongyi.   

  1. Department of Urology,Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi 214023
  • Received:2010-09-03 Online:2010-12-28 Published:2015-01-24

摘要: 目的 比较腹腔镜下前列腺癌根治术(Laparoscopic radical prostatectom,LRP)经腹腔与经腹膜外途径的临床效果。方法 对54例前列腺癌患者行经腹腔镜前列腺癌根治术,其中经腹腔39例,经腹膜外15例。对两组患者术前、术中和术后临床参数和并发症发生率、术后肿瘤学和排尿状况等资料进行统计学分析比较。结果 54例手术均获成功,经腹腔与经腹膜外两组手术时间分别为(256±45)min和(263±62)min,P=0.96;出血量分别为(335±296)mL和(352±314)mL,P=0.13;切缘阳性15.4%和13.3%,P=0.61;尿失禁23.1%和20.0%,P=0.61,差异均无统计学意义。两组术后留置导尿时间分别为(14.2±2.7)d和(11.2±3.3)d,P<0.001;肠功能恢复时间分别为(2.8±0.6)d和(2.0±0.7)d,P=0.04;术后住院时间分别为(17.2±3.5)d和(12.2±3.7)d,P<0.001,两组比较差异均有统计学意义(P<0.05)。结论 腹腔镜下前列腺癌根治术经腹膜外与经腹腔途径相比具有视野清晰、对腹腔器官影响小、术后恢复快、术后住院时间短等优点,具有临床应用优势。

Abstract: Objective To compare clinical features and results between transperitoneal laparoscopic radical prostatectomy and extraperitoneal laparoscopic radical prostatectomy.Methods 54 prostate cancer patients succeed treated with laparoscopic radical prostatectomy.Among them,39 cases had been done transperitoneally and 15 cases had been done extraperitoneally.The recorded pre-,peri-,and postoperative parameters and complications,and evaluated the oncological and functional results were collected and compared between the two different approaches.Results All the surgeries had completed successfully in 54 patients.For transperitoneal approach and extraperitoneal approach,the operating time was(256±45)min and(263±62)min(P=0.96),blood loss was(335±296)mL and(352±314)mL(P=0.13),positive surgical margin was 15.4% and 13.3%(P=0.61),Incontinence was 23.1% and 20.0%(P=0.61),all showed no significant differences between the 2 groups.Between two groups catheterization time was(14.2±2.7)d and(11.2±3.3)d(P<0.001),intestinal functional recovery time was(2.8±0.6)d and(2.0±0.7)d(P=0.04),length of hospital stay was(17.2±3.5)d and(12.2±3.7)d(P<0.001).There were significant differences regarding the postoperative recovery time of the two groups.Conclusions Laparoscopic radical prostatectomy is feasible and safe in clinical practice.Extraperitoneal approach has better vision,less impact on abdominal organs,faster recovery and shorter hospital stay comparing to transperitoneal approach.

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