摘要
目的:比较两种入路方式在机器人辅助腹腔镜下根治性前列腺切除术中的应用效果,以期为临床提供有效参考。方法:对2022年1月—2025年1月吉林省肿瘤医院收治的104例前列腺癌患者开展机器人辅助腹腔镜下根治性前列腺切除术,将其随机分为试验组(n=52,采用前入路方式)和对照组(n=52,采用后入路方式)。比较两组患者的手术相关指标、术后不同阶段的尿控情况、术后并发症发生情况及生活质量。结果:与对照组相比,试验组患者术中出血量更少,手术时间、术后导尿管留置时间及术后住院时间更短(P<0.05);两组患者术后并发症发生率及导尿管拔除后1 d(T1)、1个月(T2)、3个月(T3)的完全尿控率比较,无统计学差异(P>0.05);术前及术后3个月,试验组与对照组患者的前列腺癌治疗功能评估量表(FACT-P)、健康调查简表-36项版(SF-36)评分组间比较,差异均无统计学意义(P>0.05);但术后3个月,两组患者的FACT-P、SF-36评分均较术前提高(P<0.05)。结论:在机器人辅助腹腔镜下根治前列腺切除术中,前、后入路方式的安全性相当,患者尿控情况良好,术后生活质量均有确切改善,但与后入路方式相比,前入路方式能缩短手术及术后恢复时间,减少术中出血。
Objective:To compare the clinical outcomes of two surgical approaches in robot-assisted laparoscopic radical prostatectomy(RALRP)and provide evidence-based references for clinical practice.Methods:104 prostate cancer patients who were treated at Jilin Cancer Hospital between January 2022 and January 2025 were enrolled and randomly divided into the experimental group(n=52,using anterior approach in RALRP)and the control group(n=52,using posterior approach in RALRP).Surgical parameters,urinary continence at different postoperative stages,complication rates,and quality of life(QoL)were compared between the two groups.Results:Compared with the control group,the experimental group had significantly lower intraoperative blood loss,less operative time,shorter catheterization duration and length of hospital stay(P<0.05).No statistically significant differences were observed in complication rates or complete urinary continence rates at 1 day(T1),1 month(T2),and 3 months(T3)after catheter removal(P>0.05).Both groups showed similar functional assessment of cancer therapy-prostate(FACT-P)and the MOS item short form health survey-36(SF-36)scores before surgery and 3 months after surgery(P>0.05),though significant improvements from baseline were observed in the groups at 3 months after surgery(P<0.05).Conclusion:Anterior and posterior approaches has comparable safety and urinary continence outcomes in RALRP,with confirmed improvements in QoL.However,the anterior approach has advantages in reducing surgical time,blood loss,and recovery duration compared to the posterior approach.
作者
周昌东
刘丽影
杨洋洋
肖健
孙凯
田玉新
ZHOU Changdong;LIU Liying;YANG Yangyang;XIAO Jian;SUN Kai;TIAN Yuxin(Department of Urology,Jilin Cancer Hospital,Changchun 130012,China)
出处
《机器人外科学杂志(中英文)》
2025年第12期2120-2125,共6页
Chinese Journal of Robotic Surgery
基金
吉林省卫生健康科技能力提升项目(2023LC069)。
