前列腺穿刺术后短期内行腹腔镜前列腺癌根治术的应用研究

摘要

目的 探讨前列腺穿刺后不同间隔时间行腹腔镜前列腺癌根治术对手术难度及手术效果的影响.方法 回顾性分析2012年5月至2015年8月期间于大连医科大学附属第二医院泌尿外科由同一术者完成腹膜外途径腹腔镜前列腺癌根治术患者48例,依据穿刺至手术的间隔时间分为A、B两组,A组25例患者为前列腺穿刺术后6周内行手术治疗,B组23例患者为6周后行手术治疗.评估患者手术时间、术中出血量、切缘阳性率、术后尿控情况及术后住院时间等指标.结果 所有患者均顺利接受腹膜外途径腹腔镜前列腺癌根治术,A组平均手术时间(160±63.5) rnin,B组平均手术时间(165±66.7) min,A组患者术中出血量为(180.2±96.3)mL,B组患者术中出血量为(190.5±102.1) mL,A组患者术后切缘阳性率为16.0％,B组患者术后切缘阳性率为17.4％,A组患者术后平均住院天数(9.5±3.6)d,B组患者术后平均住院天数(10.2 ±4.1)d,术后随访6个月,A、B两组各有2例患者不能自主控尿,尿失禁发生率分别为8.0％和8.7％,以上5项指标差异均无统计学意义.结论 前列腺穿刺后短期内行腹腔镜前列腺癌根治术(6周内)不影响手术难度及手术效果.%Objective To discuss whether different intervals after prostate biopsy affect the operation difficulty and operative effect of laparoscopic radical prostatectomy.Methods We retrospectively analyzed 48 cases of laparoscopic radical prostatectomy from May 2012 to August 2015 by the same Surgeon.According to the time interval between biopsy and surgery,the patients were divided into two groups.The A group included 25 patients and had extraperitoneal laparoscopic radical prostatectomy after 6 weeks post prostate biopsy.The B group included 23 patients and received surgery within 6 weeks post biopsy.The operation time,intraoperative blood loss,cutting edge positive rate,postoperative urinary control situation and postoperative length of hospital stay and relevant indicators were analyzed.Results All patients successfully received extraperitoneal laparoscopic radical prostatectomy with smooth surgical processes.The average surgery times were (160 ±63.5) min and (165 ±66.7) min in group A and B,respectively.The intraoperative blood loss was (180.2 ± 96.3) mL in group A,and (190.5 ± 102.1) mL in group B;A group postoperative cut edge positive rate was 16.0％,B group postoperative cut edge positive rate was 17.4％.The average postoperative hospitalization was (9.5 ± 3.6) d in group A,and (10.2 ± 4.1) d in group B.During postoperative follow-up of 6 months,2 patients each in group A and B cannot master urine with urinary incontinence rates 8.0％ and 8.7％,respectively.The operation difficulty and operation effect indexes had no statistical significance between A and B two groups.Conclusion Laparoscopic radical prostatectomy shortly after prostate biopsy (within 6 weeks) does not affect the operation difficulty and operation effect.