CAJ | 학술논문

目的：评估经腹膜外途径前列腺癌根治术的临床治疗及探讨减少术后并发症的方法。方法对2012年6月至2015年5月本院收治的28例行经腹膜外途径前列腺癌根治术患者的临床资料进行回顾性分析，全部顺利完成手术。结果手术时间140-380min，平均190min。术中出血量100-870ml平均230ml，有1例既往行阑尾切除术术区粘连较重分离时出血较多输血，其余病例均无并发症发生。术后组织切缘均为阴性；术后病理回示Gleason评分为6-9分，平均8分。术后2周拔出尿管。随访2～31个月，所有患者排尿通畅，其中25例昼夜排尿完全控尿，3例夜间有轻微遗尿。术后1个月复查PSA 28例均<0.02 ng/L，复查未发现直肠指检及影像检查未发现局部复发和远处转移。结论经腹膜外途径腹腔镜入路LRP在减少创伤、减少出血方面具有明显的优势，手术解剖位置清晰，术中视野显露好，手术并发症少，术后病人疼痛明显减少，术后恢复快，术区美观及明显缩短患者住院时间等优点。
목적：평고경복막외도경전렬선암근치술적림상치료급탐토감소술후병발증적방법。방법대2012년6월지2015년5월본원수치적28례행경복막외도경전렬선암근치술환자적림상자료진행회고성분석，전부순리완성수술。결과수술시간140-380min，평균190min。술중출혈량100-870ml평균230ml，유1례기왕행란미절제술술구점련교중분리시출혈교다수혈，기여병례균무병발증발생。술후조직절연균위음성；술후병리회시Gleason평분위6-9분，평균8분。술후2주발출뇨관。수방2～31개월，소유환자배뇨통창，기중25례주야배뇨완전공뇨，3례야간유경미유뇨。술후1개월복사PSA 28례균<0.02 ng/L，복사미발현직장지검급영상검사미발현국부복발화원처전이。결론경복막외도경복강경입로LRP재감소창상、감소출혈방면구유명현적우세，수술해부위치청석，술중시야현로호，수술병발증소，술후병인동통명현감소，술후회복쾌，술구미관급명현축단환자주원시간등우점。
Objective To evaluate the clinical treatment of radical resection of prostate cancer and explore the methods of reducing postoperative complications. Methods 28 cases of radical resection for prostate cancer treated by peritoneal resection and underwent surgical treatment from June 2012 to May 2015 were retrospectively analyzed. Results The operation time was 140-380min, the average time was 190min. The average bleeding volume of 100-870ml was 230ml, among which 1 cases ever underwent appendectomy and transfused because of the larger bleeding amount. 2 weeks after operation, catheter was pulled out. Followed up for 2 to 31 months, all patients had normal urination, including 25 cases of complete could control urination normally during the day and night, 3 cases had mild nocturnal enuresis. Ng/L<0.02 was found in 1 cases after 28 months, and no recurrence and metastasis were found in the re-examination imaging examination of the rectum. Conclusion Extraperitoneal laparoscopic approach into the road and LRP can reduce trauma and bleeding.It has obvious advantages including clear surgical anatomy position, good exposure during operation, less complications, little postoperative pain of patients, quick postoperative recovery, good appearance of operation area and significantly shortened patients hospitalization time, etc.