Comparison of the clinical effects of 3D and 2D laparoscopic radical prostatectomy for prostate cancer

doi:10.3877/cma.j.issn.1674-3253.2021.02.010

Abstract

Abstract:

Objective

To compare the clinical efficacy of 3D-LRP and 2D-LRP laparoscopic radical prostatectomy (LRP) for prostate cancer.

Methods

124 patients with prostate cancer admitted to the urology department of Second Affiliated Hospital of Hainan Medical College from July 2017 to July 2019 were included. According to different surgical methods, 37 patients in the 3D-LRP group underwent 3D-LRP, while 87 patients in the 2D-LRP group underwent 2D-LRP. Statistical software SPSS 21.0 was used for data analysis to compare the perioperative indicators, complications, postoperative follow-up results and other clinical indicators of the two groups.

Results

(1)The 3D-LRP group was superior to the 2D-LRP group in terms of operation time, intraoperative blood loss, urethral reconstruction time, indwelling catheter time, and length of hospital stay, with statistically significant differences (P<0.05). The positive rate of intraoperative reserved nerve and resection margin was lower in the 3D-LRP group than in the 2D-LRP group, but the difference was not statistically significant (P>0.05). (2)The incidence of anastomotic leakage, urethral stricture, and lymphatic leakage between the two groups were not statistically different (P>0.05); The incidence of urinary incontinence in the 3D-LRP group was lower than that in the 2D-LRP group after catheter removal, and the difference was statistically significant (P<0.05). (3)The erectile dysfunction in the 3D-LRP group was significantly less than that in the 2D-LRP group at 12months after surgery, and the difference was statistically significant (P<0.05). (4)The recovery of urinary control in the 3D-LRP group at 1 month, 3 months, 6 months, and 12 months after the catheter was removed was better than that of the 2D-LRP group, but there were no statistical difference (P>0.05); There was 1 case of PCa recurrence in 3D-LRP group and 3 cases of recurrence in 2D-LRP group 3 months after operation, and there was no significant difference between the two groups (P>0.05).

Conclusion

Compared with 2D-LRP, 3D-LRP has a better effect, faster postoperative recovery and lower incidence of complications, but no significant effect has been observed in the short-term efficacy, so it is worthy of promotion.

Key words: 3D laparoscope, Prostate cancer, Radical resection of prostate cancer, Clinical efficacy

Hualei Chen, Xiaoan Zhuo, Xiaoli Zhuo, Xianping Che, Xinming Hu. Comparison of the clinical effects of 3D and 2D laparoscopic radical prostatectomy for prostate cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(02): 130-134.

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Figures/Tables 5

References 16

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组别	例数	年龄[岁，(±s)]	术前PSA[ng/ml，(±s)]	白蛋白[g/L，(±s)]	BMI[kg/m²，(±s)]	高血压（例）
组别	例数	年龄[岁，(±s)]	术前PSA[ng/ml，(±s)]	白蛋白[g/L，(±s)]	BMI[kg/m²，(±s)]	有	无
3D-LRP组	37	58±7	18±9	39.2±3.3	22±5	10	27
2D-LRP组	87	57±6	19±10	38.6±4.3	22±7	21	66
统计值		t=1.120	t=-0.182	t=0.758	t=0.299	χ²=0.116
P值		0.265	0.856	0.450	0.765	0.013
组别	糖尿病（例）		前列腺体积[ml，(±s)]	T分期（例）				Gleason评分（例）
组别	有	无	前列腺体积[ml，(±s)]	T1	T2a	T2b	T2c	≤6	7	≥8
3D-LRP组	8	29	37±9	8	11	14	4	15	16	6
2D-LRP组	18	69	39±9	12	37	30	8	39	37	11
统计值	χ²=0.014		t=-0.993	χ²=2.237				χ²=0.354
P值	0.907		0.323	0.525				0.838

组别	例数	年龄[岁，(±s)]	术前PSA[ng/ml，(±s)]	白蛋白[g/L，(±s)]	BMI[kg/m²，(±s)]	高血压（例）
组别	例数	年龄[岁，(±s)]	术前PSA[ng/ml，(±s)]	白蛋白[g/L，(±s)]	BMI[kg/m²，(±s)]	有	无
3D-LRP组	37	58±7	18±9	39.2±3.3	22±5	10	27
2D-LRP组	87	57±6	19±10	38.6±4.3	22±7	21	66
统计值		t=1.120	t=-0.182	t=0.758	t=0.299	χ²=0.116
P值		0.265	0.856	0.450	0.765	0.013
组别	糖尿病（例）		前列腺体积[ml，(±s)]	T分期（例）				Gleason评分（例）
组别	有	无	前列腺体积[ml，(±s)]	T1	T2a	T2b	T2c	≤6	7	≥8
3D-LRP组	8	29	37±9	8	11	14	4	15	16	6
2D-LRP组	18	69	39±9	12	37	30	8	39	37	11
统计值	χ²=0.014		t=-0.993	χ²=2.237				χ²=0.354
P值	0.907		0.323	0.525				0.838

组别	例数	手术时间[min，(±s)]	术中出血量[ml，(±s)]	尿道重建时间[min，(±s)]	留置尿管时间[d，(±s)]	术后引流时间[d，(±s)]	胃肠蠕动恢复时间[d，(±s)]	住院时间[d，(±s)]	术中保留神经[实际保留/拟保留，侧]	切缘阳性[例(%)]
3D-LRP组	37	188±29	111±26	25±5	9.4±2.0	3.2±1.0	1.9±0.5	15.2±2.0	46/54	9(24.3)
2D-LRP组	87	207±23	131±31	31±7	11.1±2.2	3.5±1.1	1.9±0.7	17.6±2.6	68/98	34(39.1)
统计值		t=-3.968	t=-3.261	t=-4.968	t=-3.983	t=1.457	t=-0.148	t=-4.911	χ²=0.646	χ²=2.495
P值		<0.001	<0.001	<0.001	<0.001	0.073	0.441	<0.001	0.421	0.114

组别	例数	手术时间[min，(±s)]	术中出血量[ml，(±s)]	尿道重建时间[min，(±s)]	留置尿管时间[d，(±s)]	术后引流时间[d，(±s)]	胃肠蠕动恢复时间[d，(±s)]	住院时间[d，(±s)]	术中保留神经[实际保留/拟保留，侧]	切缘阳性[例(%)]
3D-LRP组	37	188±29	111±26	25±5	9.4±2.0	3.2±1.0	1.9±0.5	15.2±2.0	46/54	9(24.3)
2D-LRP组	87	207±23	131±31	31±7	11.1±2.2	3.5±1.1	1.9±0.7	17.6±2.6	68/98	34(39.1)
统计值		t=-3.968	t=-3.261	t=-4.968	t=-3.983	t=1.457	t=-0.148	t=-4.911	χ²=0.646	χ²=2.495
P值		<0.001	<0.001	<0.001	<0.001	0.073	0.441	<0.001	0.421	0.114

组别	例数	吻合口瘘	尿失禁	尿道狭窄	淋巴漏
3D-LRP组	37	0(0.00)	12(32.43)	1(2.70)	1(2.70)
2D-LRP组	87	3(3.45)	49(56.32)	5(5.75)	8(9.20)
χ²值		-	5.928	0.071	0.804
P值		0.554	0.015	0.791	0.370

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