摘要
目的探讨三维(3D)腹腔镜下前列腺根治性术治疗对前列腺癌患者围术期指标、术后尿控恢复、切缘阳性率的影响。方法我院收治的前列腺患者80例,按照手术方式分为3D腹腔镜术组(43例)和2D腹腔镜术组(37例),两组术后均接受3个月随访。对比两组术前术后膜部尿道长度(MUL)差值、手术时间、术中出血量、膀胱颈-尿道吻合时间、住院时间、拔除导管后2、8、12、24周尿控恢复情况、术后切缘阳性率及保留勃起功能成功率。结果治疗后3D腹腔镜术组手术时间、术中出血量、膀胱颈-尿道吻合时间及住院时间短于2D腹腔镜术组,术前术后MUL差值小于2D腹腔镜术组,拔除导管后8、12周控尿率高于2D腹腔镜术组,保留勃起功能成功率高于2D腹腔镜术组(P<0.05),切缘阳性率与2D腹腔镜术组相比差异无统计学意义(P>0.05)。结论3D腹腔镜下前列腺根治性术治疗前列腺可明显缩短手术时间、术中出血量、膀胱颈-尿道吻合时间及住院时间,切缘阳性率低,且保留勃起功能成功率较高,有助于早期控尿功能的恢复。
Objective To explore the effects of three-dimensional(3 D)laparoscopic radical prostatectomy on perioperative indexes,postoperative urinary control recovery and positive of incisal margin of patients with prostatic cancer.Methods Eighty patients with prostatic cancer in our hospital were divided into 3 D laparoscopic surgery group(n=43)and 2 D laparoscopic surgery group(n=37)according to the surgical procedures.The patients were followed up for 3 months after operation.The difference of preoperative and postoperative membranous urethral length(MUL),operative time,intraoperative blood loss,bladder neck-urethral anastomosis time,hospital stay,urinary control recovery before and after 2,8,12,and 24 weeks after catheter removal,the positive rate of postoperative margin and the success rate of erectile function retention were compared between the two groups.Results The operative time,intraoperative blood loss,bladder neck-urethral anastomosis time and hospital stay in the 3 D laparoscopic surgery group were shorter or less than those in the 2 D laparoscopic surgery group(P<0.05).The difference of preoperative and postoperative MUL was significantly less in the 3 D laparoscopic surgery group than that in the 2 D laparoscopic surgery group(P<0.05).The urinary control rate after 8 and 12 weeks of catheter removal was higher in the 3 D laparoscopic surgery group than that in 2 D laparoscopic surgery group(P<0.05).The success rate of erectile function retention in the 3 D laparoscopic surgery group was higher than that in 2 D laparoscopic surgery group(P<0.05).However,there was no significant difference in positive rate of margin between the two groups(P>0.05).Conclusion 3 D laparoscopic radical prostatectomy for prostatic cancer can significantly shorten or decrease the operative time,intraoperative blood loss,bladder neck-urethral anastomosis time and hospital stay.It has low positive rate of margin,and high success rate of erectile function retention.It also helps the recovery of early urinary control function.
作者
何洁
任启文
张红
HE Jie;REN Qi-wen;ZHANG Hong(Department of Urology,Nanchong City Center Hospital,Nanchong 637000,China;Department of Pediatrics,Nanchong City Center Hospital,Nanchong 637000,China)
出处
《实用医院临床杂志》
2020年第3期195-197,共3页
Practical Journal of Clinical Medicine
关键词
3D腹腔镜
前列腺根治性术
围术期
尿控恢复
切缘阳性率
3D laparoscopic
Radical prostatectomy
Perioperative period
Urinary control recovery
Positive rate of margin
