机器人辅助腹腔镜与标准腹腔镜治疗局限性前列腺癌的疗效对比

目的 对比机器人辅助腹腔镜与标准腹腔镜治疗在局限性前列腺癌的疗效，旨在为前列腺癌患者手术治疗方案提供参考依据。方法 回顾性分析我院2016年10月—2019年12月收治的328例局限性前列腺癌患者，其中腹腔镜组（n=176）行标准腹腔镜根治性前列腺切除术，机器人组（n=152）行机器人根治性前列腺切除术。比较两组患者资料，包含术前一般资料、术中出血量、手术时间、膀胱颈尿道吻合时间，术后进食时间、盆腔引流管拔除时间、尿管拔除时间、住院时间、住院总费用及术后随访尿控和性功能恢复情况。结果 机器人组术中手术时间、术中出血量及尿道膀胱颈吻合时间均优于腹腔镜组，差异有统计学意义（P <0.05）；机器人组术后住院天数、留置尿管时间明显短于腹腔镜组，差异有统计学意义（P <0.05）；机器人组术后进食时间晚于腹腔镜组，住院总费用明显高于腹腔镜组，差异有统计学意义（P <0.05）；两组盆腔引流管拔出时间对比，差异无统计学意义（P> 0.05）；机器人组即刻尿控、术后1、3个月尿控率均高于腹腔镜组，差异有统计学意义（P <0.05），两组术后6、12个月尿控率比较，差异...

Comparison of Surgical Cure Effect of Da Vinci Robot-assisted and Standard Laparoscopic Radical Prostatectomy in Patients With Localized Prostate Cancer

Objective To compare surgical cure effect for localized prostate cancer between Da Vinci robot-assisted laparoscopic radical prostatectomy(RARP)and standard laparoscopic radical prostatectomy(LSRP),the purpose is to provide reference for surgical treatment of patients with localized prostate cancer.Methods A total of 328 patients with localized prostate cancer treated in our hospital from October 2016 to December 2019 were analyzed retrospectively.The laparoscopic group(n=176)underwent LSRP and the robot group(n=152)underwent RARP,The data of the two groups were compared,including preoperative general data,intraoperative bleeding,operation time,bladder neck urethral anastomosis time,postoperative eating time,pelvic drainage tube removal time,urinary tube removal time,hospitalization time,hospitalization expenses,postoperative follow-up urinary control and sexual function recovery.Results The intraoperative operation time,intraoperative bleeding and urethral bladder neck anastomosis time in the robot group were better than those in the laparoscopy group,with differences were statistically significant(P<0.05);the postoperative hospitalization days and indwelling catheter time in the robot group were significantly shorter than those in the laparoscopy group,with differences were statistically significant(P<0.05);the postoperative eating time in the robot group was later than that in the laparoscopy group,and the total hospitalization cost was significantly higher than that in the laparoscopy group,with differences were statistically significant(P<0.05);there was no significant difference in the time of pelvic drainage tube extraction between the two groups(P>0.05);the immediate urinary control and the urinary control rate at 1 and 3 months after operation in the robot group were significantly higher than those in the laparoscopy group,with differences were statistically significant(P<0.05).There was no significant difference in the urinary control rate at 6 and 12 months after operation between the two groups(P>0.05);there was no significant difference in IIEF-5 scores between the two groups at 3,6 and 12 months after operation(P>0.05).Conclusion Compared with the standard laparoscopic radical prostatectomy,the Da Vinci robot-assisted has obvious advantages in the treatment of localized prostate cancer,because it has shorter operation time,less intraoperative blood loss,shorter postoperative hospital stay and earlier recovery of urinary control.The Da Vinci robot-assisted can achieve satisfactory clinical efficacy in the treatment of localized prostate cancer,but the hospitalization expenses is significantly higher than the LSRP,which is the main reason of restricting its development in China.