中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
11期
1032-1034
,共3页
谈宜傲%周林玉%陈昊%肖峻%宣强%吴绍山
談宜傲%週林玉%陳昊%肖峻%宣彊%吳紹山
담의오%주림옥%진호%초준%선강%오소산
前列腺癌%腹腔镜%腹膜外途径%前列腺癌根治术
前列腺癌%腹腔鏡%腹膜外途徑%前列腺癌根治術
전렬선암%복강경%복막외도경%전렬선암근치술
Prostate cancer%Laparoscopy%Extraperitoneal%Radical prostatectomy
目的 评价经腹膜外途径腹腔镜前列腺癌根治术治疗局限性前列腺癌的可行性及临床价值.方法 回顾性分析26例前列腺癌患者行经腹膜外途径腹腔镜前列腺癌根治术的临床资料,患者术前行前列腺穿刺活检或前列腺电切术后病理均证实为前列腺癌,Gleason评分6～8分.结果 26例手术顺利完成,无中转开放手术.手术时间120 ～ 270 min,平均165 min;术中出血量180～ 650 ml,平均320ml;术后留置尿管时间12～19 d,平均14 d.术后轻度尿失禁6例,通过尿道括约肌锻炼后1～3个月后可满意控尿.术后病理均证实为前列腺癌;切缘阳性2例,术后加用内分泌治疗.术后随访2～36个月,生化复发5例,予内分泌治疗后控制满意.结论 经腹膜外腹腔镜前列腺癌根治术具有创伤小、出血少、恢复快,是一种安全可行的手术方式,有可能代替开放手术,可能成为治疗局限性前列腺癌的首选治疗方法.
目的 評價經腹膜外途徑腹腔鏡前列腺癌根治術治療跼限性前列腺癌的可行性及臨床價值.方法 迴顧性分析26例前列腺癌患者行經腹膜外途徑腹腔鏡前列腺癌根治術的臨床資料,患者術前行前列腺穿刺活檢或前列腺電切術後病理均證實為前列腺癌,Gleason評分6～8分.結果 26例手術順利完成,無中轉開放手術.手術時間120 ～ 270 min,平均165 min;術中齣血量180～ 650 ml,平均320ml;術後留置尿管時間12～19 d,平均14 d.術後輕度尿失禁6例,通過尿道括約肌鍛煉後1～3箇月後可滿意控尿.術後病理均證實為前列腺癌;切緣暘性2例,術後加用內分泌治療.術後隨訪2～36箇月,生化複髮5例,予內分泌治療後控製滿意.結論 經腹膜外腹腔鏡前列腺癌根治術具有創傷小、齣血少、恢複快,是一種安全可行的手術方式,有可能代替開放手術,可能成為治療跼限性前列腺癌的首選治療方法.
목적 평개경복막외도경복강경전렬선암근치술치료국한성전렬선암적가행성급림상개치.방법 회고성분석26례전렬선암환자행경복막외도경복강경전렬선암근치술적림상자료,환자술전행전렬선천자활검혹전렬선전절술후병리균증실위전렬선암,Gleason평분6～8분.결과 26례수술순리완성,무중전개방수술.수술시간120 ～ 270 min,평균165 min;술중출혈량180～ 650 ml,평균320ml;술후류치뇨관시간12～19 d,평균14 d.술후경도뇨실금6례,통과뇨도괄약기단련후1～3개월후가만의공뇨.술후병리균증실위전렬선암;절연양성2례,술후가용내분비치료.술후수방2～36개월,생화복발5례,여내분비치료후공제만의.결론 경복막외복강경전렬선암근치술구유창상소、출혈소、회복쾌,시일충안전가행적수술방식,유가능대체개방수술,가능성위치료국한성전렬선암적수선치료방법.
Objective To evaluate the feasibility and the clinical value of extraperitoneal laparoscopic radical prostatectomy in treatment of localized prostate cancer.Methods Clinical data of 26 patients with localized prostate cancer treated with extraperitoneal laparoscopic radical prostatectomy were analyzed retrospectively.All patients were pathologic diagnosed with prostate cancer by preoperative prostate biopsy or transurethral resection of prostate surgery.Gleason grade was from 6-8.Results Twenty-six operations were successfully accomplished ,without converting to open approach.The operative time was 120-270 min(mean was 165 min) ,the intraoperative blood loss was 180-650 ml (mean was 320 ml) ,indwelling catheter time 12-19 d (mean was 14 d).There were 6 cases with little uroclepsia, satisfactory with urination after contract urethral sphincter for 1-3 Months.Pathologically confirmed all prostate cancer;2 cases of positive margins after surgery plus endocrine therapy.All the cases were followed up from 2 to 36 months.The biochemical recurrence was 5 cases who had undergone endocrine therapy.Conclusion Extraperitoneal laparoscopic radical prostatectomy is a safe and feasible procedure with little trauma, small bleeding and fast recovery which is well worth popularizing.Replace open surgery may become frist choice therapeutic method for localized prostate cancer.
