【作者】 李建华；

【导师】 刘秉乾；

【作者基本信息】 郑州大学 ， 泌尿外科（专业学位）， 2016， 硕士

【摘要】 目的:比较普通腹腔镜下根治性前列腺切除术(laparoscopic radical prostatectomy,LRP)与经耻骨后根治性前列腺切除术(retropubic radical prostatectomy,RRP)治疗临床局限性前列腺癌(prostate cancer,PCa)的疗效。方法回顾性分析2008年1月至2014年12月于我院泌尿外科行根治性前列腺切除术(radical prostatectomy,RP)的119名PCa患者的临床资料,其中63人行LRP,56人行RRP。比较两组两组患者的年龄、体重指数(body mass index,BMI)、术前前列腺特异性抗原(prostate-specific antigen,PSA)、前列腺体积、术前Gleason评分、术前T分期、手术时间、术中出血量、肠道功能恢复时间、术后住院时间、并发症、切缘阳性(positive surgical margin,PSM)情况、术后1年生化复发(biochemical recurrence,BCR)情况。结果(1)LRP和RRP组术前数据比较,差异都没有统计学意义(P值均大于0.05)。(2)LRP和RRP组手术时间分别为(182.7±48.0)min、(246.7±53.8)min(P<0.05),术中出血量分别为(199.0±108.6)ml、(369.3±137.9)ml(P<0.05),肠道功能恢复时间分别为(3.2±0.9)天、(4.3±1.1)天(P<0.05),术后住院时间分别为(12.8±3.6)天、(15.8±3.5)天(P<0.05),两组数据比较差异都具有统计学意义。(2)LRP和RRP组并发症比较,P<0.05,差异具有统计学意义。(4)LRP和RRP组PSM情况以及术后1年BCR情况比较,P值均小于0.05,差异都没有统计学意义。结论LRP较RRP手术时间缩短,术中出血量明显减少,肠道功能恢复时间较快,术后住院时间缩短,且并发症较少。LRP和RRP治疗局限性PCa的效果相似。更多还原

【Abstract】 ObjectivesTo compare the clinical efficacy of laparoscopic radical prostatectomy(LRP)and retropubic radical prostatectomy(RRP)for the treatment of localized prostate cancer(PCa). MethodsFrom January 2008 to December 2014, 119 PCa cases who underwent radical prostatectomy(RP)at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Of the 119 patients,63 cases underwent LRP while 56 cases conducted RRP.The age,body mass index(BMI),PSA level, prostate volume, preoperative Gleason score, clinical T stage,operating time, blood loss, intestinal function recovery time, postoperative hospital stay, complication rate, positive surgical margin(PSM)rate and 1-year biochemical recurrence(BCR)rate were compared between the 2 groups. Results(1)There were no significant differences between the LRP and RRP groups with respect to age,BMI, PSA level, prostate volume, preoperative Gleason score and clinical T stage.(2)The differences of operative time(LRP:182.7±48.0 min,RRP:246.7±53.8 min,P<0.05),blood loss(199.0±108.6ml,369.3±137.9ml, P<0.05),intestinal function recovery time(3.2±0.9天,4.3±1.1天,P<0.05),postoperative hospital stay(12.8±3.6天,15.8±3.5天,P<0.05)and complication rate(P<0.05)were significantly between the 2 groups.(3)There were no significant differences in PSM rate(P<0.05)and 1-year BCR rate(P<0.05) between the 2 groups. ConclusionsIn the present cohort,compared with RRP, the operative time,the blood loss during the surgery, the intestinal function recovery time,the postoperative hospital stay and the complication rate could be significantly reduced in LRP. Both LRP and RRP have good outcomes in oncological control.更多还原