腹膜外径路腹腔镜前列腺癌根治术(附65例报告)

目的:探讨腹膜外径路腹腔镜PCa根治术的初步体会。方法:经腹膜外径路进行腹腔镜PCa根治术65例。结果:64例(98.5%)成功,手术时间100～440min,平均172min。出血量150～800ml,平均340ml,7例(10.8%)患者输红细胞悬液2～4U。1例术中发生直肠损伤,2例术后发生尿外渗。6例(9.2%)患者术后病理提示切缘阳性。58例(89.2%)患者术后3个月尿控良好。结论:腹膜外径路腹腔镜PCa根治术是安全、可行的。且因避免了术中、术后对腹腔内肠管的干扰,降低了手术并发症,利于术后患者的恢复,值得在临床推广应用。

Extraperitoneal Laparoscopic Radical Prostatectomy for Prostate Cancer : A Report of 65 Cases

OBJECTIVE: To report the experience with extraperitoneal laparoscopic radical prostatectomy (EP-LRP) in the treatment of prostate cancer. METHODS: Sixty-five patients with diagnosed localized prostate cancer underwent extraperitoneal laparoscopic radical prostatectomy. RESULTS: The procedures were successful in 64 cases. Mean operating time was 172 min (range 100 to 440 min). Mean blood loss was 340 ml (range 150 to 800 ml). Seven (10.8%) of the 65 patients received transfusion with MAP of 24 units. Rectal injury occurred in 1 patient, 2 developed urethrovesical anastomotic leakage, 6 (9.2%) had positive surgical margins, 58 (89.2%) were fully continent with urination 3 months after the operation. CONCLUSION: EP-LRP, as a safe and feasible procedure for prostate cancer, which avoides violation of the peritoneal cavity, potentially decreases the risk of intraoperative complications and further reduces postoperative morbidity, is well worth popularizing.