腹腔镜前列腺癌根治术42例报告

目的:探讨腹腔镜前列腺癌根治术(laparoscopic radical prostatectomy,LRP)治疗局限性前列腺癌的可行性并总结临床体会。方法:回顾分析2008年12月至2011年3月为42例前列腺癌患者行腹膜外入路腹腔镜前列腺癌根治术的临床资料。结果:42例手术均获成功,无一例周围脏器损伤。手术时间120～250 min,平均170 min。术中出血量120～750 ml,平均260 ml,11例术中输血400～600 ml。术后住院21～23 d,平均22 d。拔除导尿管时间18～22 d,平均20 d。6例患者术后7天内发生尿漏,均经充分引流和牵拉尿管后痊愈。25例出现轻～中度尿失禁,经提肛等辅助治疗,4～12周后明显缓解或消失。术后病检:pT1c14例,pT212例,pT3a16例。术后PSA均<4.0 ng/ml。结论:经腹膜外入路行腹腔镜前列腺癌根治术可行、安全、有效,患者创伤小、康复快、并发症少,值得推广应用。

Clinical analysis of laparoscopic radical prostatectomy: with a report of 42 cases

Objective:To investigate the feasibility and experience of laparoscopic radical prostatectomy(LRP) in treatment of localized prostate cancer.Methods:The clinical data of 42 patients with localized prostate cancer who underwent extraperitoneal laparoscopic radical prostatectomy from Dec.2008 to Mar.2011 were analyzed retrospectively.Results:All the operations were successfully completed.The operating time was 120-250 min(mean,170 min)and the estimated blood loss was 120-750 ml(mean,260 ml).11 patients required a blood transfusion(400-600 ml) during the operation.There was no surrounding organs injuried.The postoperative hospita1 stay was 21-23 days(mean,22 days).The catheterization time was 18-22 days(mean,20 days).In 6 patients presenting with urinary leakage,and urinary incontinence occurred in 25 patients and disappeared after supportive treatment.Pathological examinations revealed stage pT1c in 14 patients,stage pT2 in 12,and stage pT3 in 16.The postoperative prostate-specific antigen(PSA)level was below 4.0 ng/ml.Conclusions:LRP,as a safe and feasible procedure for prostate cancer,which avoids violation of the peritoneal cavity,potentially decreases the risk of intraoperative complications and further reduces postoperative morbidity,is well worth popularizing.