【摘要】：目的:比較普通腹腔鏡下根治性前列腺切除術(shù)(laparoscopic radical prostatectomy,LRP)與經(jīng)恥骨后根治性前列腺切除術(shù)(retropubic radical prostatectomy,RRP)治療臨床局限性前列腺癌(prostate cancer,PCa)的療效。方法回顧性分析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術(shù)(radical prostatectomy,RP)的119名PCa患者的臨床資料,其中63人行LRP,56人行RRP。比較兩組兩組患者的年齡、體重指數(shù)(body mass index,BMI)、術(shù)前前列腺特異性抗原(prostate-specific antigen,PSA)、前列腺體積、術(shù)前Gleason評(píng)分、術(shù)前T分期、手術(shù)時(shí)間、術(shù)中出血量、腸道功能恢復(fù)時(shí)間、術(shù)后住院時(shí)間、并發(fā)癥、切緣陽(yáng)性(positive surgical margin,PSM)情況、術(shù)后1年生化復(fù)發(fā)(biochemical recurrence,BCR)情況。結(jié)果(1)LRP和RRP組術(shù)前數(shù)據(jù)比較,差異都沒(méi)有統(tǒng)計(jì)學(xué)意義(P值均大于0.05)。(2)LRP和RRP組手術(shù)時(shí)間分別為(182.7±48.0)min、(246.7±53.8)min(P0.05),術(shù)中出血量分別為(199.0±108.6)ml、(369.3±137.9)ml(P0.05),腸道功能恢復(fù)時(shí)間分別為(3.2±0.9)天、(4.3±1.1)天(P0.05),術(shù)后住院時(shí)間分別為(12.8±3.6)天、(15.8±3.5)天(P0.05),兩組數(shù)據(jù)比較差異都具有統(tǒng)計(jì)學(xué)意義。(2)LRP和RRP組并發(fā)癥比較,P0.05,差異具有統(tǒng)計(jì)學(xué)意義。(4)LRP和RRP組PSM情況以及術(shù)后1年BCR情況比較,P值均小于0.05,差異都沒(méi)有統(tǒng)計(jì)學(xué)意義。結(jié)論LRP較RRP手術(shù)時(shí)間縮短,術(shù)中出血量明顯減少,腸道功能恢復(fù)時(shí)間較快,術(shù)后住院時(shí)間縮短,且并發(fā)癥較少。LRP和RRP治療局限性PCa的效果相似。
[Abstract]:Objective: to compare the clinical efficacy of laparoscopic radical prostatectomy (laparoscopic radical prostatectomy,LRP) and retropubic radical prostatectomy (retropubic radical prostatectomy,RRP) in the treatment of localized prostate cancer (prostate cancer,PCa). Methods Clinical data of 119 PCa patients undergoing radical prostatectomy (radical prostatectomy,RP) in urology from January 2008 to December 2014 in our hospital were retrospectively analyzed, of which 63 cases were treated with LRP,56 and RRP.. Age, body mass index (body mass index,BMI), preoperative prostate specific antigen (prostate-specific antigen,PSA), prostate volume, preoperative Gleason score, preoperative T stage, operative time, intraoperative bleeding volume, recovery time of intestinal function, postoperative hospitalization time were compared between the two groups. Complications, positive margin of (positive surgical margin,PSM, 1 year after operation biochemical recurrence (biochemical recurrence,BCR). Results (1) the preoperative data of LRP and RRP were compared. There was no significant difference (P > 0. 05). (2). The operative time of LRP and RRP group was (182.7 鹵48. 0) min, (246.7 鹵53. 8) min (P 0.05), the amount of intraoperative bleeding was (199.0 鹵108.6) ml, (369.3 鹵137.9) ml (P0.05), the recovery time of intestinal function was (3. 2 鹵0. 9) days, (4. 3 鹵1. 1) days (P0.05), the postoperative hospitalization time was (12. 8 鹵3. 6) days and (15. 8 鹵3. 5) days (P0.05). The differences were statistically significant. (2) the complications of LRP and RRP were significantly higher than that of RRP (P 0.05). (4) the PSM in LRP and RRP and the BCR in 1 year after operation were all less than 0.05, and the difference was not statistically significant. Conclusion compared with RRP, LRP has shorter operative time, less intraoperative bleeding, faster recovery time of intestinal function, shorter postoperative hospital stay, and less complications. LRP and RRP have similar effect in the treatment of localized PCa.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R737.25

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