摘要
目的探讨腹膜外入路腹腔镜前列腺癌根治术治疗前列腺癌的临床疗效及对免疫功能的影响。方法选择杭州市富阳区第一人民医院泌尿外科于2017年1月至2019年12月期间收治的64例早期前列腺癌患者,随机分为两组,每组各32例,对照组接受开放性前列腺癌根治术治疗,观察组采用腹膜外入路腹腔镜前列腺癌根治术治疗,比较两组围手术期临床指标、术后并发症的发生情况及外周血T淋巴细胞亚群的变化,并随访1年的生化复发率。结果观察组手术时间明显高于对照组,术中出血量明显少于对照组,术后导尿管留置、肠道功能恢复、住院时间均明显短于对照组,术后并发症发生率低于对照组,差异均有统计学意义(P<0.05);术后1 d,两组患者CD3^(+),CD4^(+),CD4^(+)/CD8^(+)水平明显低于术前,但观察组高于对照组(P<0.05);术后7 d,观察组患者CD3^(+),CD4^(+),CD4^(+)/CD8^(+)恢复到术前水平(P>0.05),对照组术后14 d恢复到术前水平(P>0.05)。术后1年,观察组与对照组生化复发率比较(12.50%vs.9.34%),差异无统计学意义(P>0.05)。结论腹膜外入路腹腔镜前列腺癌根治术有创伤小、术后并发症发生率低及术后恢复快的优点,且对机体细胞免疫功能的抑制作用弱。
Objective To investigate the clinical efficacy of extraperitoneal laparoscopic radical prostatectomy for prostate cancer and its influence on immune function.Methods Sixty-four patients with early prostate cancer who were admitted to the Department of Urology,the First People′s Hospital of Fuyang District of Hangzhou City from January 2017 to December 2019 were selected and randomly divided into two groups with 32 patients each.The control group received open radical prostatectomy,while the observation group received extraperitoneal laparoscopic radical prostatectomy.The perioperative clinical indicators,postoperative complications and changes in T-lymphocyte subsets in peripheral blood,and the biochemical recurrence rate during 1-year follow-up were compared between the two groups.Results The operation time of the observation group was significantly longer than that of the control group,and the amount of intraoperative blood loss was significantly less than that of the control group.The postoperative catheter indwelling time,intestinal function recovery time,and length of stay were significantly shorter than those of the control group,and the incidence of postoperative complications was lower than that in the control group,with statistically significant differences(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+) in the two groups at 1 day after the operation were significantly lower than those before the operation,but the levels of the observation group was higher than those of the control group(P<0.05).CD3^(+),CD4^(+),CD4^(+)/CD8^(+) in the observation group recovered to the preoperative level at 7 days after the operation(P>0.05),and the indicators in the control group recovered to the preoperative level at 14 days after the operation(P>0.05).One year after the operation,there was no statistically significant difference in the biochemical recurrence rate between the observation group and the control group(12.50%vs.9.34%)(P>0.05).Conclusion Extraperitoneal laparoscopic radical prostatectomy shows the advantages of small trauma,low incidence of postoperative complications and quick postoperative recovery,and it has a weak inhibition on the body′s cellular immune function.
作者
孟繁华
徐皖江
MENG Fanhua;XU Wanjiang(Department of Urology,the First People′s Hospital of Fuyang District of Hangzhou City,Hangzhou311400,China)
出处
《中国现代医生》
2021年第24期66-69,共4页
China Modern Doctor
基金
浙江省自然基金资助项目(LGF21H160018)。
关键词
腹膜外入路
腹腔镜前列腺癌根治术
前列腺癌
免疫功能
生化复发
Extraperitoneal approach
Laparoscopic radical prostatectomy
Prostate cancer
Immune function
Biochemical recurrence
