腹腔镜与机器人辅助腹腔镜前列腺癌根治性切除的回顾分析

doi:10.19558/j.cnki.10-1020/r.2019.06.005

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摘要 目的：通过对比分析机器人辅助腹腔镜下根治性前列腺癌切除术（RLRP）与传统腹腔镜下根治性前列腺癌切除术（LRP）的术中优劣和术后近远期疗效之间的差异,评价RLRP术的可行性。方法：回顾性分析2017年1月–2018年7月西京医院泌尿外科收治的826例前列腺癌患者资料,其中行RLRP治疗538例（RLRP组）,行LRP治疗288例（LRP组）。对比分析两组患者术中情况（手术时间、术中出血量、输血率）、术后情况（下床时间、切缘阳性率、漏尿率、引流管拔除时间、术后住院时间）及随访情况（随访12个月时的完全尿控率和生化复发率）。结果：术中两组患者术中出血量、输血率均差异无统计学意义（P>0.05）;RLRP组手术时间少于LRP组,差异有统计学意义（P<0.05）。术后,两组患者切缘阳性率、漏尿率比较,均差异无统计学意义（P>0.05）;RLRP组下床时间、引流管拔除时间、术后住院时间少于LRP组,差异有统计学意义（P<0.05）。随访期间两组患者完全尿控率、生化复发率均差异无统计学意义（P>0.05）。结论：RLRP技术安全可行,与LRP相比,能减少手术时间,促进患者术后早期恢复,但远期疗效方面不存在优势。

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	于小平
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关键词 ：输机器人辅助腹腔镜下根治性前列腺癌切除术, 腹腔镜下根治性前列腺癌切除术, 近期疗效, 远期疗效

Abstract：Objective： To evaluate the feasibility and safety of robotic-assisted laparoscopic radical prostatectomy (RLRP) by comparing the differences between the advantages and disadvantages and the short-term and long-term outcomes of RLRP and conventional laparoscopic radical prostatectomy (LRP). Methods： A retrospective analysis was performed on 826 patients with prostate cancer admitted to the Department of Urology, Xijing Hospital from January 2017 to July 2018, including 538 patients with RLRP (RLRP group) and 288 patients with LRP (LRP group). The intraoperative conditions (surgery time, intraoperative blood loss, blood transfusion rate), postoperative condition (out of bed time, positive margin, leakage rate, drainage tube removal time, postoperative hospital stay), follow-up (complete urinary control rate and biochemical recurrence rate at 12th month of follow-up) were compared between the two groups. Results： There were no significant differences in the intraoperative blood loss and blood transfusion rate between the two groups (P > 0.05). The operative time in the RLRP group was significantly shorter than that in the LRP group (P < 0.05). There was no significant difference in the positive margin and leakage rate between the two groups (P > 0.05). The RLRP group had a shorter out of bed time, drainage tube removal time, and postoperative hospital stay than the LRP group (P < 0.05). There was no significant difference in the rate of complete urinary control and biochemical recurrence between the two groups (P > 0.05). Conclusion： RLRP is safe and feasible. Compared with LRP, RLRP has the advantages of shortening operation time and promoting early recovery after surgery. However, there is no advantage in long-term efficacy.

Key words： robot-assisted laparoscopic radical prostatectomy laparoscopic radical prostatectomy short-term efficacy long-term efficacy

收稿日期: 2019-08-08

ZTFLH:

R737.25

通讯作者: 阮东丽,745501416@qq.com

引用本文:

于小平, 阮东丽, 杨艳, 赵雪利. 腹腔镜与机器人辅助腹腔镜前列腺癌根治性切除的回顾分析[J]. 微创泌尿外科杂志, 2019, 8(6): 380-384.
YU Xiaoping, RUAN Dongli, YANG Yan, ZHAO Xueli. Retrospective analysis of robot-assisted LRP and traditional LRP. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(6): 380-384.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1547.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2019/V8/I6/380

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