现代泌尿外科杂志
現代泌尿外科雜誌
현대비뇨외과잡지
JOURNAL OF MODERN UROLOGY
2015年
4期
234-236
,共3页
朱耀%韩成涛%杨晓群%戴波%张海梁%施国海%沈益君%朱一平%王朝夫%叶定伟
硃耀%韓成濤%楊曉群%戴波%張海樑%施國海%瀋益君%硃一平%王朝伕%葉定偉
주요%한성도%양효군%대파%장해량%시국해%침익군%주일평%왕조부%협정위
前列腺癌根治术%腹腔镜%开放手术%切缘阳性%整体组织切片
前列腺癌根治術%腹腔鏡%開放手術%切緣暘性%整體組織切片
전렬선암근치술%복강경%개방수술%절연양성%정체조직절편
radical prostatectomy%laparoscopic%open operation%positive surgical margin%whole mount slide
目的：通过配对比较腹腔镜和开放性前列腺癌根治术两种不同手术方式，明确术后切缘阳性的影响因素。方法回顾性分析我院2012年12月至2014年7月行前列腺癌根治术230例患者，其中行开放手术136例，腹腔镜94例，术后通过前列腺整体组织大切片的方式由我院泌尿病理医师阅片评估术后切缘阳性情况及部位。结果通过倾向指数评分配对比较腹腔镜和开放手术效果，其中腹腔镜94例占40．9％。根据患者年龄、PSA水平和穿刺Gleason评分进行配对，最终选取腔镜和开放手术患者各94例进行分析。两组人群的年龄、PSA水平、穿刺Gleason评分和病理T分期均无显著差异。年龄、PSA、穿刺Gleason综合、T分期和手术方式5个变量进行多因素分析，可发现仅有术后病理T 分期可作为切缘阳性的独立预后因素。无论是总体切缘阳性率还是不同部位的切缘阳性率，腹腔镜手术和开放手术相比均没有显著差异（P＞0．05）。结论两组人群的手术切缘阳性率没有显著性差异，提示腹腔镜手术提供了不劣于开放手术的肿瘤切除的完整性。
目的：通過配對比較腹腔鏡和開放性前列腺癌根治術兩種不同手術方式，明確術後切緣暘性的影響因素。方法迴顧性分析我院2012年12月至2014年7月行前列腺癌根治術230例患者，其中行開放手術136例，腹腔鏡94例，術後通過前列腺整體組織大切片的方式由我院泌尿病理醫師閱片評估術後切緣暘性情況及部位。結果通過傾嚮指數評分配對比較腹腔鏡和開放手術效果，其中腹腔鏡94例佔40．9％。根據患者年齡、PSA水平和穿刺Gleason評分進行配對，最終選取腔鏡和開放手術患者各94例進行分析。兩組人群的年齡、PSA水平、穿刺Gleason評分和病理T分期均無顯著差異。年齡、PSA、穿刺Gleason綜閤、T分期和手術方式5箇變量進行多因素分析，可髮現僅有術後病理T 分期可作為切緣暘性的獨立預後因素。無論是總體切緣暘性率還是不同部位的切緣暘性率，腹腔鏡手術和開放手術相比均沒有顯著差異（P＞0．05）。結論兩組人群的手術切緣暘性率沒有顯著性差異，提示腹腔鏡手術提供瞭不劣于開放手術的腫瘤切除的完整性。
목적：통과배대비교복강경화개방성전렬선암근치술량충불동수술방식，명학술후절연양성적영향인소。방법회고성분석아원2012년12월지2014년7월행전렬선암근치술230례환자，기중행개방수술136례，복강경94례，술후통과전렬선정체조직대절편적방식유아원비뇨병리의사열편평고술후절연양성정황급부위。결과통과경향지수평분배대비교복강경화개방수술효과，기중복강경94례점40．9％。근거환자년령、PSA수평화천자Gleason평분진행배대，최종선취강경화개방수술환자각94례진행분석。량조인군적년령、PSA수평、천자Gleason평분화병리T분기균무현저차이。년령、PSA、천자Gleason종합、T분기화수술방식5개변량진행다인소분석，가발현부유술후병리T 분기가작위절연양성적독립예후인소。무론시총체절연양성솔환시불동부위적절연양성솔，복강경수술화개방수술상비균몰유현저차이（P＞0．05）。결론량조인군적수술절연양성솔몰유현저성차이，제시복강경수술제공료불렬우개방수술적종류절제적완정성。
Objective To evaluate the positive surgical margin of laparoscopic and open radical prostatectomy by pairing comparison analysis .Methods A retrospective analysis of 230 consecutive radical prostatectomy cases treated at our center during Dec .2012 and Jul .2014 was conducted ,among which 136 cases were open and 94 were laparoscopic operations .Postop-erative whole mount slides were reviewed by urinary pathologists to evaluate positive surgical margin status and positions .Re-sults The propensity score matching index was used to evaluate laparoscopic and open surgery patients .Paired matching was conducted according to patient age ,PSA level and biopsy Gleason score .As a result ,94 pairs of laparoscopic and open surgery patients were selected .There were no statistical difference in age ,PSA level ,Gleason score ,and pathological T stage between the two groups .Only T stage was found to be an independent prognostic factor of positive surgical margin .There were no sig-nificant differences (P>0 .05) in the overall rate of positive margins or positive rate of different parts between the two groups . Conclusions There is no significant difference in the positive rate of surgical margin of the two groups ,suggesting that lapa-roscopic operation is not inferior to the open operation in tumor resection and integrity .
