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中华腔镜泌尿外科杂志(电子版) ›› 2017, Vol. 11 ›› Issue (02) : 105 -108. doi: 10.3877/cma.j.issn.1674-3253.2017.02.007

所属专题: 文献

临床研究

腹腔镜前列腺癌根治术的临床改进
魏灿1, 井俊峰1, 杨晓亮1, 吴畏1, 席俊华1, 陈运1, 杨振兴1, 王伟1, 应全胜1, 张艳斌1,()   
  1. 1. 230011 合肥市第二人民医院泌尿外科
  • 收稿日期:2016-04-06 出版日期:2017-04-01
  • 通信作者: 张艳斌

The clinical application of modified laparoscopic radical prostatectomy

Can Wei1, Junfeng Jing1, Xiaoliang Yang1, Wei Wu1, Junhua Xi1, Yun Chen1, Zhenxing Yang1, Wei Wang1, Quansheng Ying1, Yanbin Zhang1,()   

  1. 1. Department of Urology, the Second People's Hospital of Hefei, Anhui 230011, China
  • Received:2016-04-06 Published:2017-04-01
  • Corresponding author: Yanbin Zhang
  • About author:
    Corresponding author: Zhang Yanbin, Email:
引用本文:

魏灿, 井俊峰, 杨晓亮, 吴畏, 席俊华, 陈运, 杨振兴, 王伟, 应全胜, 张艳斌. 腹腔镜前列腺癌根治术的临床改进[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(02): 105-108.

Can Wei, Junfeng Jing, Xiaoliang Yang, Wei Wu, Junhua Xi, Yun Chen, Zhenxing Yang, Wei Wang, Quansheng Ying, Yanbin Zhang. The clinical application of modified laparoscopic radical prostatectomy[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2017, 11(02): 105-108.

目的

探讨改良式腹腔镜前列腺癌根治术的操作技巧和疗效。

方法

我科2014年3月至2015年9月共行16例腹腔镜前列腺癌根治术(LRP),回顾性分析其临床资料。其中7例行标准术式的LRP(标准组),同期另有9例在标准组的基础上进行手术技巧改进(改良组),改良采用了筋膜内背深静脉复合体免缝扎技术,并改进一系列措施以保护血管神经束、尿道括约肌,降低膀胱尿道吻合口张力。比较改良组和标准组的手术时间、术中出血量、尿管留置天数和术后尿控率等临床指标。

结果

标准组的手术时间、出血量、尿管留置天数分别为230 min、371 ml、21.4 d,而改良组的上述指标分别为197 min、324 ml、16.7 d,其中手术时间差异有统计学意义(P<0.05),改良组术后30 d、90 d和180 d控尿率均高于标准组。

结论

改良式腹腔镜前列腺癌根治术的改进处理方式能提高手术效率,减少手术时长,能早期拔除尿管,有利于术后尿控恢复,且不增加术中出血量,是一种安全有效的手术方法,值得推广。

Objective

To evaluate the technique and clinical outcomes of modified laparoscopic radical prostatectomy(LRP).

Methods

Sixteen cases of LRP from March 2014 to September 2015 were retrospectively analyzed, 7 cases were enrolled in standard group, other contemporaneous 9 cases were improved group. Dorsal vascular complex ligation-free method and other improved skills were adopted to protect neurovascular bundle and urethral sphincter. Bladder-urethral anastomotic tension was reduced. Indicators such as operative time, blood loss, indwelling catheter days and urinary continence were studied.

Results

The operation time, blood loss, urine tube indwelling days of the standard group were 230 minutes, 371 ml and 21.4 days respectively, the corresponding indexes of the improved group were 197 minutes, 324 ml and 16.7 days respectively. The operative time of improved group was obviously reduced than standard group (P<0.05). The 30 days, 90 days and 180 days postoperative continence rates of the improved group were higher than standard group.

Conclusion

The delicate skills in the modified LRP can improve the efficiency of operation, reduce the operation time, remove catherer earlier without increasing bleeding, and the urinary continence can recover better. Modified LRP is safe and effective and worth to be popularized.

表2 标准组与改良组参数比较
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