全盆底筋膜重建技术对腹腔镜根治性前列腺癌切除术患者疗效及对肿瘤标志物和Gleason评分的影响

目的探讨全盆底筋膜重建技术对腹腔镜根治性前列腺癌切除术患者疗效及对肿瘤标志物和Gleason评分的影响。方法我院行腹腔镜根治性前列腺癌切除术患者112例,按照入院时间先后依次分为观察组60例和对照组52例,对照组在术中均不行盆底筋膜重建,观察组在术中均行盆底筋膜重建,比较两组一般手术指标、手术前后Gleason评分、术后3个月控尿和勃起功能及血清中前列腺特异性抗原(PSA)、血管内皮生长因子(VEGF)和胰岛素样生长因子-Ⅰ(IGF-I)水平。结果两组手术时间及术中出血量比较差异无统计学意义(P>0.05);手术前后,两组Gleason评分比较差异无统计学意义(P>0.05);术后3个月,观察组完全控尿和勃起功能恢复情况均优于对照组(P<0.05);手术前后,两组PSA、VEGF和IGF-I水平比较差异无统计学意义(P>0.05),术后两组PSA、VEGF和IGF-I水平均低于术前(P<0.05)。结论将全盆底筋膜重建技术应用在腹腔镜根治性前列腺癌切除术中,不仅能够保证手术的效率和安全性,而且还有利于促进患者勃起和控尿功能的早日恢复;同时发现是否行盆底筋膜重建对肿瘤标志物水平和Gleason评分没有影响。

The curative effect of total pelvic floor reconstruction on patients undergoing laparoscopic radical prostatectomy and its influence on tumor markers and Gleason score

Objective To investigate the curative effect of total pelvic floor reconstruction in patients undergoing laparoscopic radical prostatectomy and its effect on tumor markers and Gleason score.Methods One hundred and twelve patients undergoing laparoscopic radical prostatectomy in our hospital were divided into observation group(n=60)and control group(n=52)according to the time of admission.The control group did not while the observation group received pelvic floor reconstruction during operation.The general operation indicators,Gleason scores before and after operation,continence and erectile function were compared between the two groups.The levels of serum prostate-specific antigen(PSA),vascular endothelial growth factor(VEGF)and insulin-like growth factor-I(IGF-I)were also compared between the two groups.Results There was no significant difference in the operation time and intraoperative blood loss between the two groups(P<0.05).No significant differences were found in the Gleason scores between the two groups before and after operation(P>0.05).After 3 months of operation,the complete continence and the erectile function recovery of the observation group were significantly better than those of the control group(P<0.05).Before and after surgery,there were no significant differences in PSA,VEGF and IGF-I levels between the two groups(P>0.05),but the above levels in the two groups were significantly lower after operation when compared to before operation(P<0.05).Conclusion The application of total pelvic floor reconstruction in laparoscopic radical prostatectomy can not only ensure the efficiency and safety of the operation,but also help the early recovery of the erection and urinary control function of the patients.Meanwhile,it is found that the changes in tumor markers and the influence of Gleason score are not significantly related to the implementation of pelvic floor reconstruction.