摘要
目的比较经腹膜外腹腔镜前列腺癌根治术(ELRP)与经腹腔腹腔镜前列腺癌根治术(TLRP)治疗前列腺癌的临床效果。方法选择2016年1月至2020年12月驻马店市中心医院收治的82例前列腺癌患者为研究对象,所有患者行前列腺癌根治术,根据手术路径将患者分为TLRP组和ELRP组,每组41例。记录2组患者的手术时间、术中出血量、腹腔引流管留置时间、导尿管留置时间、术后肠道功能恢复时间和住院时间。2组患者分别于术前及术后1个月进行尿动力学检查,测定排泄后残余尿量(PVR)、最大尿流率(Q_(max))和最大尿流率时逼尿肌压力(Pdet-Q_(max))。观察2组患者术中及术后6个月内并发症的发生情况,观察患者术后3、6个月时的控尿情况。结果ELRP组患者术中出血量显著少于TLRP组,手术时间、腹腔引流管留置时间、导尿管留置时间、术后肠道功能恢复时间和住院时间显著短于TLRP组(P<0.05)。2组患者术前PVR、Q_(max)、Pdet-Q_(max)比较差异无统计学意义(P>0.05);2组患者术后1个月PVR显著低于术前,Q_(max)、Pdet-Q_(max)显著高于术前(P<0.05);术后1个月,ELRP组患者PVR显著低于TLRP组,Q_(max)、Pdet-Q_(max)显著高于TLRP组(P<0.05)。ELRP组和TLRP组患者并发症发生率分别为4.88%(2/41)、9.76%(4/41),2组患者并发症发生率比较差异无统计学意义(χ^(2)=0.625,P>0.05)。ELRP组患者术后3、6个月完全控尿率分别为70.73%(29/41)、95.12%(39/41),TLRP组患者术后3、6个月完全控尿率分别为48.78%(20/41)、78.05%(32/41);ELRP组患者术后3、6个月完全控尿率显著高于TLRP组(χ^(2)=4.266、4.507,P<0.05)。结论相比于TLRP,ELRP能有效缩短前列腺癌患者的手术时间,减少术中出血量,加快患者术后恢复,改善尿动力,提高患者术后完全控尿率。
Objective To compare the clinical effect of extraperitoneal laparoscopic radical prostatectomy(ELRP)and transabdominal laparoscopic radical prostatectomy(TLRP)in the treatment of prostate cancer.Methods A total of 82 patients with prostate cancer admitted to Zhumadian Central Hospital from January 2016 to December 2020 were selected as the research subjects.All patients underwent radical prostatectomy,and the patients were divided into TLRP group and ELRP group according to the surgical route,with 41 cases in each group.The operation time,intraoperative bleeding,abdominal drainage tube indwelling time,urinary catheter indwelling time,postoperative gastrointestinal function recovery time and hospitalization time of the patients in the two groups were recorded.The patients in the two groups underwent urodynamic examination before and one month after operation,respectively;and the postvoid residual(PVR),the maximum urine flow rate(Q_(max))and the detrusor pressure at the maximum urine flow rate(Pdet-Q_(max))were measured.The complications during the operation and within six months after operation of the patients in the two groups were observed.The urination control of the patients was observed at three and six months after operation.Results The intraoperative bleeding of patients in the ELRP group was significantly less than that in the TLRP group,and the operation time,abdominal drainage tube indwelling time,urinary catheter indwelling time,postoperative gastrointestinal function recovery time and hospitalization time were significantly shorter than those in the TLRP group(P<0.05).There was no significant difference in preoperative PVR,Q_(max) and Pdet-Q_(max) of patients between the two groups(P>0.05).The PVR of patients at one month after operation was significantly lower than that before operation,and the Q_(max) and Pdet-Q_(max) were significantly higher than those before operation in the two groups(P<0.05).One month after operation,the PVR of patients in the ELRP group was significantly lower than that in the TLRP group,and the Q_(max) and Pdet-Q_(max) were significantly higher than those in the TLRP group(P<0.05).The incidence of complications of patients in the ELRP group and the TLRP group was 4.88%(2/41)and 9.76%(4/41),respectively.There was no significant difference in the incidence of complications of patients between the two groups(χ^(2)=0.625,P>0.05).The complete voiding control rate of patients in the ELRP group at three and six months after operation was 70.3%(29/41)and 95.12%(39/41),respectively.The complete voiding control rate of patients at three and six months after operation in the TLRP group was 48.78%(20/41)and 78.05%(32/41),respectively.The complete voiding control rate of patients in the ELRP group was significantly higher than that in the TLRP group at three and six months after operation(χ^(2)=4.266,4.507;P<0.05).Conclusion Compared with the TLRP,the ELRP can effectively shorten the operation time of patients with prostate cancer,reduce intraoperative bleeding,promote postoperative recovery,improve urodynamics and postoperative complete urinary control rate.
作者
朱海松
ZHU Haisong(Department of Urology,Zhumadian Central Hospital,Zhumadian 463000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2022年第7期626-630,共5页
Journal of Xinxiang Medical University
关键词
前列腺癌
前列腺癌根治术
腹腔镜手术
经腹腔途径
经腹膜外途径
prostate cancer
radical prostatectomy
laparoscopic operation
transabdominal approach
extraperitoneal approach
