机器人辅助腹腔镜根治性前列腺切除:经腹与腹膜外入路术后对肝肾功能的影响

目的 通过对比经腹与腹膜外入路,达芬奇机器人辅助腹腔镜根治性前列腺切除术后对肝肾功能的影响,以期为前列腺癌患者围手术期安全性提供临床依据,并为肝肾功能不全患者手术方案的制定提供参考.方法 回顾性分析2014年3月至2020年11月赤峰市医院收治的95例前列腺癌患者的临床资料,其中58例行经腹入路机器人辅助根治性前列腺切...

Robot-assisted laparoscopic radical prostatectomy:effects of transperitoneal and extraperitoneal approaches on hepatic and renal function

Objective By comparing the changes of hepatic and renal function after transperitoneal Da Vinci robot-assisted laparoscopic radical prostatectomy(TP-RARP)and extraperitoneal Da Vinci robot-assisted laparoscopic radical prostatectomy(EP-RARP),to provide the clinical evidence for the perioperative safety of patients with prostate cancer and the reference for the surgical planning of patients with hepatic and renal insufficiency.Methods A retrospective analysis was performed on the clinical data of 95 patients with prostate cancer undergoing TP-RARP(n=58)and EP-RARP(n=37)between March 2014 and November 2020.The preoperative clinical data,intraoperative and postoperative treatment related indexes and laboratory examination results of liver and renal functions were compared between two groups.Results The average operation time,postoperative hospital stay and the time required for postoperative gastrointestinal function recovery in EP-RARP group were significantly shorter than those in TP-RARP group(P<0.01).Compared with those before operation,the levels of total bilirubin and conjugated bilirubin increased,and the levels of total protein,albumin,globulin and blood urea nitrogen decreased significantly after operation in two groups(P<0.05).The levels of total protein,albumin and globulin in TP-RARP group were statistically lower than those in EP-RARP group(P<0.05).There were no significant difference in serum creatinine,glomerular filtration rate and creatinine clearance rate befor and after operation and between two groups(P>0.05).The level of prostate specific antigen was significantly lower than that before operation in both groups(P<0.05).Conclusions Both TP-RARP and EP-RARP have a significant impact on hepatic function,while the latter has less impact.However,two surgical methods have no significant effect on renal function.