本文選題：腹腔鏡　切入點(diǎn)：前列腺癌　出處：《第一軍醫(yī)大學(xué)》2006年博士論文

【摘要】：腹腔鏡前列腺癌根治術(shù)(laparoscopic radical prostatectomy，LRP)目前在歐洲和美國已成為臨床上治療局限性前列腺癌的常規(guī)手術(shù)，有取代開放性前列腺癌根治術(shù)的趨勢，在中國還處于初始階段。該技術(shù)是兼顧微創(chuàng)性和開放性手術(shù)優(yōu)點(diǎn)的新技術(shù)，對病人而言，具有微創(chuàng)、早期拔除尿管、失血量少近乎不輸血、住院時(shí)間短、術(shù)后恢復(fù)快、術(shù)中術(shù)后并發(fā)癥明顯減少的優(yōu)點(diǎn)；對手術(shù)醫(yī)生而言，具有手術(shù)視野的高清晰度、尿道膀胱吻合的精確性和嚴(yán)密性好的優(yōu)點(diǎn)。該手術(shù)不會因微創(chuàng)性而影響術(shù)后的腫瘤學(xué)結(jié)果，，功能學(xué)結(jié)果與開放手術(shù)相似。 但該手術(shù)要求高和需要相當(dāng)長的學(xué)習(xí)曲線，剛開展該手術(shù)時(shí)存在手術(shù)時(shí)間較長，增加發(fā)生并發(fā)癥的危險(xiǎn)性的缺點(diǎn)，現(xiàn)在術(shù)后功能學(xué)結(jié)果如排尿功能和性功能仍不滿意。對前列腺神經(jīng)血管束和海綿體神經(jīng)、尿道橫紋括約肌的神經(jīng)支配的神經(jīng)解剖學(xué)方面目前仍有許多不清楚的地方，如何減少手術(shù)陽性切緣，尤其是醫(yī)源性人為手術(shù)陽性切緣，尚需改進(jìn)手術(shù)技巧和方法來解決，還缺乏該手術(shù)的鏡下解剖學(xué)研究。這些就成為臨床解剖學(xué)者和外科醫(yī)生所面臨的迫切任務(wù)。 本研究利用固定尸體及新鮮尸體、活體腹腔鏡觀察來闡明前列腺神經(jīng)血管束和正常前列腺及周圍結(jié)構(gòu)的解剖組織學(xué)特點(diǎn)、尿道橫紋括約肌的控尿神經(jīng)支配及微創(chuàng)前列腺癌根治術(shù)的鏡下解剖學(xué)特點(diǎn)。
[Abstract]:Laparoscopic radical prostatectomy (LRP) has become a routine procedure for the treatment of localized prostate cancer in Europe and the United States. It has a tendency to replace open radical prostatectomy, and is still in its infancy in China.This technique is a new technique which takes into account the advantages of minimally invasive and open surgery. For the patients, it has the advantages of minimally invasive, early extubation, less blood loss, less blood loss, shorter hospitalization time, faster postoperative recovery, and less complications during and after operation.For the surgeon, it has the advantages of high definition of operative visual field, accuracy and strictness of urethral and bladder anastomosis.This procedure does not affect the postoperative oncology results due to minimally invasive surgery, and the functional results are similar to open surgery.However, the operation requires a long learning curve and needs a long learning curve. It has the disadvantages of long operation time and increasing the risk of complications. Now the functional results such as urination and sexual function are still unsatisfactory.There are still many unclear aspects in the neuroanatomy of the prostatic nerve vessel bundle and cavernous nerve, the innervation of the transverse sphincter of the urethra, and how to reduce the surgical positive margin, especially the iatrogenic artificial surgical positive margin.The surgical techniques and methods need to be improved and there is a lack of endoscopic anatomical study of the operation.These become clinical anatomists and surgeons facing the urgent task.In this study, the anatomical and histological characteristics of the neurovascular bundle of the prostate and the normal prostate and its surrounding structures were elucidated by using fixed and fresh cadavers and in vivo laparoscopic observation.The innervation of urethral sphincter and the anatomical features of minimally invasive radical prostatectomy for prostate cancer.
【學(xué)位授予單位】：第一軍醫(yī)大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2006
【分類號】：R737.25;R322

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 楊博;前列腺NVB及前列腺癌磁共振成像研究[D];第四軍醫(yī)大學(xué);2011年

本文編號：1688728