复杂病例行机器人辅助腹腔镜前列腺癌根治术的初步经验

目的：探讨机器人辅助腹腔镜前列腺癌根治术(robot-assisted laparoscopic prostatectomy，RALP)治疗复杂前列腺癌病例的初步经验。方法：回顾性分析中南大学湘雅三医院2015年10月至11月行RA LP的4例复杂前列腺癌患者的临床和病理资料。4例患者，年龄58~70岁，均接受过经尿道等离子镜下前列腺癌剜除术和内分泌治疗。结果：4例患者手术均获成功，基线前列腺特异抗原(prostate specifi c antigen，PSA)6.04~70.15 ng/mL，临床分期T2b~T3b，手术时间180~360 min，术中出血量50~250 mL，均未输血，手术切缘均为阴性。结论：虽然经尿道前列腺手术史和内分泌治疗史会增加手术难度，RA LP仍可用于此类复杂前列腺癌病例的治疗。

Initial experience with robot-assisted laparoscopicprostatectomy for complicated cases

Objective: To present our initial experience with robot-assisted laparoscopic prostatectomy(RA LP) for complicated cases.Methods: Clinical and pathological data from 4 complicated prostate cancer cases, who underwentRALP from October to November in 2015, were analyzed retrospectively. All the cases wereconducted transurethral plasmakinetic enucleation of prostate and hormonal therapy before RA LP.Results: All surgeries were done successfully. Th e age, baseline prostatic special antigen, clinicaltumor stage, operation time and estimated blood loss were 58–70 years, 6.04–70.15 ng/mL, T2b–T3b, 210–360 min and 50–250 mL, respectively. No blood transfusion was needed. All surgicalmargin were negative.Conclusion: Although previous transurethral surgeries and hormonal therapies may increase thediffi culty for operations, RA LP is still appropriate for the complicated cases of prostate cancer.