机器人辅助腹腔镜下根治性前列腺切除术:经腹途径与经腹膜外途径的比较分析

发布时间：2018-06-04 09:39

本文选题：机器人 + 根治性前列腺切除术　；参考：《南京医科大学学报(自然科学版)》2017年04期

【摘要】：目的:比较经腹途径与经腹膜外途径机器人辅助腹腔镜下根治性前列腺切除术的围手术期结果。方法:回顾性分析南京医科大学第一附属医院2016年6月—2016年9月53例行机器人辅助腹腔镜下根治性前列腺切除术前列腺癌患者的临床资料,其中经腹途径41例,年龄56~80岁,平均70岁;经腹膜外途径12例,年龄59~78岁,平均68岁。比较两组患者围手术期情况。结果:53例机器人辅助腹腔镜下根治性前列腺切除术均顺利完成,无中转开放手术者。比较经腹和经腹膜外两组年龄[(70.4±6.0)岁vs.(68.3±6.8)岁]、BMI[(23.7±2.5)kg/m~2vs.(24.1±3.2)kg/m~2]、术前PSA[(22.2±21.6)ng/mL vs.(14.9±9.0)ng/mL]、Gleason评分[(7.5±0.7)分vs.(7.3±0.7)分]比较差异均无统计学意义(P0.05)。经腹组和经腹膜外组的总手术时间[(223.4±26.8)min vs.(186.5±16.6)min]、装机时间[(23.6±4.9)min vs.(27.9±5.5)min]、术后肠道恢复排气时间[(2.4±0.6)d vs.(1.9±0.6)d]、术后肠道恢复排便时间[(3.6±0.5)d vs.(3.2±0.6)d]差异均有统计学意义(P0.05)。两组的术中出血量、术后双侧盆腔引流管留置时间、术后下床活动时间、术后住院时间、术后导尿管留置时间比较差异均无统计学意义(P0.05)。结论:与经腹途径比较,经腹膜外途径机器人辅助腹腔镜下根治性前列腺切除术手术时间短,术后肠道恢复时间快,在术中出血量、术后双侧盆腔引流管留置时间、术后下床活动时间、术后住院时间、术后导尿管留置时间等方面无明显差异。
[Abstract]:Objective: to compare the perioperative results of laparoscopic radical prostatectomy with transabdominal approach and extraperitoneal approach. Methods: the clinical data of 53 patients with prostatic cancer undergoing radical prostatectomy with robotic assisted laparoscopic prostatectomy from June 2016 to September 2016 in the first affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The mean age was 70 years, and the mean age was 68 years (59 78 years) in 12 patients with extraperitoneal approach. The perioperative period was compared between the two groups. Results all 53 cases of Robotic assisted laparoscopic radical prostatectomy were successfully completed and there was no conversion to open prostatectomy. There was no significant difference between the two groups (70.4 卤6.0 years old, vs.(68.3 卤6.8 years old) and preoperative PSA (22.2 卤21.6)ng/mL vs.(14.9 卤9.0)ng/mL), vs.(7.3 卤0.7 (7.5 卤0.7). There were significant differences in total operation time (223.4 卤26.8)min vs.(186.5 卤16.6)min), installation time (23.6 卤4.9)min vs.(27.9 卤5.5)min), postoperative bowel recovery time (2.4 卤0.6d vs.(1.9 卤0.6d) and postoperative bowel recovery time (3.6 卤0.5d vs.(3.2 卤0.6d) between the transabdominal group and the extraperitoneal group (P 0.05). There was no significant difference between the two groups in the amount of intraoperative bleeding, the time of bilateral pelvic drainage tube indwelling, the time of getting out of bed, the time of hospitalization and the time of catheter indwelling after operation (P 0.05). Conclusion: compared with the transabdominal approach, the operation time of robot-assisted laparoscopic prostatectomy is shorter, the recovery time of intestinal tract is faster, the amount of blood lost during the operation and the time of indwelling the bilateral pelvic drainage tube. There was no significant difference in postoperative time of bed movement, postoperative hospitalization time and postoperative catheter indwelling time.
【作者单位】：南京医科大学第一附属医院泌尿外科;
【基金】：江苏省自然科学基金(BK20141495)
【分类号】：R737.25;TP242

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