中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2011年
2期
94-98
,共5页
林天歆%黄健%江春%许可慰%叶枫%黄海%韩金利%姚友生%谢文练%张彩霞%董文%刘皓
林天歆%黃健%江春%許可慰%葉楓%黃海%韓金利%姚友生%謝文練%張綵霞%董文%劉皓
림천흠%황건%강춘%허가위%협풍%황해%한금리%요우생%사문련%장채하%동문%류호
前列腺肿瘤%前列腺根治性切除术%腹腔镜%单孔腹腔镜-内镜手术
前列腺腫瘤%前列腺根治性切除術%腹腔鏡%單孔腹腔鏡-內鏡手術
전렬선종류%전렬선근치성절제술%복강경%단공복강경-내경수술
Prostate neoplasm%Radical prostatectomy%Laparoscopic%Laparoscopic-endoscopic single-site surgery
目的 探讨使用自制多通道套管经脐切口行单孔腹腔镜下前列腺根治性切除术的方法及初步疗效.方法 2009年8月至2010年3月,对11例局限性前列腺癌患者行单孔腹腔镜下前列腺根治性切除术.经脐3 cm切口,腹膜前置入自制多通道套管,行单孔腹腔镜下双侧闭孔淋巴结清扫、前列腺根治性切除、膀胱尿道吻合术.膀胱尿道吻合采用活结套结连续缝合法完成.结果 1例增加1个套管,其余10例手术均顺利完成,无中转常规腹腔镜手术或开放手术.平均手术时间256(195～315)min,平均出血量90(20～180)ml,平均术后住院时间15.4(13～24)d,术后12 d拔除尿管.无术中并发症.术后1例出现膀胱尿道吻合口漏、2例出现淋巴漏、1例出现泌尿系感染,均经保守治疗治愈.病理报告11例手术标本切缘均阴性,清扫淋巴结阴性.患者平均随访7(3～11)个月,无肿瘤生化复发.结论 单孔腹腔镜下前列腺根治性切除术技术上可行,具有美观、微创、并发症少的特点,具有良好的短期功能和肿瘤控制效果,中长期疗效需进一步随诊观察.
目的 探討使用自製多通道套管經臍切口行單孔腹腔鏡下前列腺根治性切除術的方法及初步療效.方法 2009年8月至2010年3月,對11例跼限性前列腺癌患者行單孔腹腔鏡下前列腺根治性切除術.經臍3 cm切口,腹膜前置入自製多通道套管,行單孔腹腔鏡下雙側閉孔淋巴結清掃、前列腺根治性切除、膀胱尿道吻閤術.膀胱尿道吻閤採用活結套結連續縫閤法完成.結果 1例增加1箇套管,其餘10例手術均順利完成,無中轉常規腹腔鏡手術或開放手術.平均手術時間256(195～315)min,平均齣血量90(20～180)ml,平均術後住院時間15.4(13～24)d,術後12 d拔除尿管.無術中併髮癥.術後1例齣現膀胱尿道吻閤口漏、2例齣現淋巴漏、1例齣現泌尿繫感染,均經保守治療治愈.病理報告11例手術標本切緣均陰性,清掃淋巴結陰性.患者平均隨訪7(3～11)箇月,無腫瘤生化複髮.結論 單孔腹腔鏡下前列腺根治性切除術技術上可行,具有美觀、微創、併髮癥少的特點,具有良好的短期功能和腫瘤控製效果,中長期療效需進一步隨診觀察.
목적 탐토사용자제다통도투관경제절구행단공복강경하전렬선근치성절제술적방법급초보료효.방법 2009년8월지2010년3월,대11례국한성전렬선암환자행단공복강경하전렬선근치성절제술.경제3 cm절구,복막전치입자제다통도투관,행단공복강경하쌍측폐공림파결청소、전렬선근치성절제、방광뇨도문합술.방광뇨도문합채용활결투결련속봉합법완성.결과 1례증가1개투관,기여10례수술균순리완성,무중전상규복강경수술혹개방수술.평균수술시간256(195～315)min,평균출혈량90(20～180)ml,평균술후주원시간15.4(13～24)d,술후12 d발제뇨관.무술중병발증.술후1례출현방광뇨도문합구루、2례출현림파루、1례출현비뇨계감염,균경보수치료치유.병리보고11례수술표본절연균음성,청소림파결음성.환자평균수방7(3～11)개월,무종류생화복발.결론 단공복강경하전렬선근치성절제술기술상가행,구유미관、미창、병발증소적특점,구유량호적단기공능화종류공제효과,중장기료효수진일보수진관찰.
Objective To present our initial experience in laparoscopic radical prostatectomy performed through an umbilical incision using a home-made multichannel port. Methods From August 2009 to March 2010, we performed single-port laparoscopic radical prostatectomy in 11 patients with localized prostate cancer. A home-made multichannel port was inserted extraperitoneally through a 3-cm umbilical incision. The single port extraperitoneal procedures included obturator fossa lymphadenectomy, radical prostatectomy and urethro-vesical anastomosis, while the urethro-vesical anastomosis was performed by a slip-knot running suture technique. Data were collected and analyzed prospectively. Results All cases were completed successfully, without conversion to a standard laparoscopic approach or open surgery except adding an additional port in one case. The average operative time was 256 minutes (range195-315), and the mean blood loss was 90 ml (range 20- 180), without any blood transfusion. The postoperative hospital stay was 15.4 days (range13- 24), and the Foley catheter was removed 12 days after surgery. No intraoperative complications occurred. One patient developed a vesico-rethralanastomosis leakage, 2 had lymphatic leakage and 1 had urinary tract infection,all of the cases were managed successfully with conservative treatment. Histopathological results showed negative surgical margine and negative lymph node dissection. All patients had no biochemical relapse after an average follow-up of 7 months. Conclusions Single-port laparoscopic radical prosta tectomy is feasible, cosmetic and minimally invasive with a low complication rate and good short-term outcome. Additional investigation is needed to evaluate the long-term safety and oncologic adequacy of this new approach.
