CAJ | 학술논문

目的对比经腹和腹膜外途径腹腔镜根治性前列腺切除术的差异.方法回顾性分析2002年6月至2013年1月期间190例因前列腺癌行腹腔镜根治性前列腺切除术的患者,其中经腹腹腔镜根治性前列腺切除术患者116例,经腹膜外腹腔镜根治性前列腺切除术患者74例.比较经腹腹腔镜和腹膜外腹腔镜根治性前列腺切除临床指标(年龄、体重指数、手术时间、出血量、术后引流拔出时间,术后平均住院时间)、围手术期及术后早期并发症的差异.结果 2组患者平均年龄,身高,体重,体重指数,穿刺活检的Gleason评分及临床分期均具有可比性.与接受经腹腹腔镜根治性前列腺切除术相比,经腹膜外腹腔镜根治性前列腺切除术的手术时间短(中位数146 min,Z=-7.220,P=0.000)、术后引流时间短(中位数3d,Z=-7.115,P=0.000),术后平均住院时间短(中位数5d,Z=-7.250,P=0.000),差异有统计学意义;而2组间Gleason评分、病理分期、切缘阳性率、术中及术后早期并发症差异均无统计学意义(P＞0.05).结论与经腹腹腔镜前列腺根治性切除术相比,经腹膜外途径的手术时间更短,术后平均住院日更短,手术效果无明显差异.
목적 대비경복화복막외도경복강경근치성전렬선절제술적차이.방법 회고성분석2002년6월지2013년1월기간190례인전렬선암행복강경근치성전렬선절제술적환자,기중경복복강경근치성전렬선절제술환자116례,경복막외복강경근치성전렬선절제술환자74례.비교경복복강경화복막외복강경근치성전렬선절제림상지표(년령、체중지수、수술시간、출혈량、술후인류발출시간,술후평균주원시간)、위수술기급술후조기병발증적차이.결과 2조환자평균년령,신고,체중,체중지수,천자활검적Gleason평분급림상분기균구유가비성.여접수경복복강경근치성전렬선절제술상비,경복막외복강경근치성전렬선절제술적수술시간단(중위수146 min,Z=-7.220,P=0.000)、술후인류시간단(중위수3d,Z=-7.115,P=0.000),술후평균주원시간단(중위수5d,Z=-7.250,P=0.000),차이유통계학의의;이2조간Gleason평분、병리분기、절연양성솔、술중급술후조기병발증차이균무통계학의의(P＞0.05).결론 여경복복강경전렬선근치성절제술상비,경복막외도경적수술시간경단,술후평균주원일경단,수술효과무명현차이.
Objective To compare the transperitoneal laparoscopic radical prostatectomy procedures with extraperitoneal laparoscopic radical prostatectomy procedures to assess for differences in outcomes and complications.Methods A retrospective review 190 patients who had received laparoscopic radical prostatectomy for prostate cancer from June 2002 to January 2013.The results were compared between 116 transperitoneal laparoscopic radical prostatectomy procedures and 74 extraperitoneal laparoscopic radical prostatectomy procedures.Results The cohorts were similar in terms of mean patient age,height,weight,body mass index,Gleason score from biopsy,and clinical stage.Patients receiced extraperitoneal laparoscopic radical prostatectomy had shorter operation time (146 minutes vs.224 minutes,Z =-7.220,P =0.000),less postoperative drainage time (3 days vs.7 days,Z =-7.115,P =0.000) and shorter postoperative length of hospital stay (5 days vs.10 days,Z =-7.250,P =0.000) than patients receiced transperitoneal procedures.However,the Gleason score,pathological stage,positive margin rate,intraoperative and early postoperative complications has no differences between the 2 groups (P ＞ 0.05).Conclusions The patients who received extraperitoneal laparoscopic radical prostatectomy had shorter operative time and revovered faster recovery and the effect of surgery was similar.