本文選題：經(jīng)腹膜外　切入點(diǎn)：腹腔鏡　出處：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的探討經(jīng)腹膜外途徑腹腔鏡前列腺癌根治術(shù)（ELRP）治療局限性前列腺癌的臨床價(jià)值，總結(jié)術(shù)后并發(fā)癥的原因及處理經(jīng)驗(yàn)。 方法回顧分析2011年8月至2013年6月我科28例局限性前列腺癌患者行ELRP的臨床資料。年齡:54歲～76歲，平均年齡68.6歲。術(shù)前病理報(bào)告均為前列腺癌，術(shù)前臨床分期T1期11例，T2期17例。Gleason評(píng)分3~9分。前列腺特異性抗原（PSA）1.02ng/ml~88.76ng/ml。 結(jié)果28例手術(shù)均順利完成，手術(shù)時(shí)間125～210min，平均160min。術(shù)中出血量100～850ml，平均245ml，，1例予以術(shù)中輸血。術(shù)后住院時(shí)間7～26d，平均11.2d。術(shù)后留置尿管時(shí)間15～28d，平均20.5d。3例患者發(fā)生尿漏，經(jīng)保守治療后均痊愈。8例患者出現(xiàn)尿失禁，7例經(jīng)過(guò)膀胱訓(xùn)練及盆底肌鍛煉等康復(fù)治療后尿控能力均得到恢復(fù)，1例出現(xiàn)真性尿失禁。無(wú)周?chē)K器損傷。2例出現(xiàn)尿道狹窄,分別經(jīng)尿道擴(kuò)張和膀胱頸口狹窄切開(kāi)術(shù)后排尿均恢復(fù)通暢。術(shù)后病理切緣陽(yáng)性1例。術(shù)后隨訪5月～23月，平均10.8月，未發(fā)現(xiàn)腫瘤復(fù)發(fā)或轉(zhuǎn)移，術(shù)后3月PSA＜0.14ng/ml。 結(jié)論ELRP是一種治療局限性前列腺癌切實(shí)可行的微創(chuàng)手術(shù)方法，熟練掌握手術(shù)操作技巧是達(dá)到手術(shù)安全、有效的關(guān)鍵。
[Abstract]:Objective to evaluate the clinical value of laparoscopic radical prostatectomy (ELRP) in the treatment of localized prostate cancer, and to summarize the causes of postoperative complications and experience in management.Methods from August 2011 to June 2013, 28 patients with localized prostate cancer underwent ELRP.The average age is 68.6 years.The preoperative pathological findings were all prostate cancer. The preoperative clinical staging was T 1 stage and T 2 stage 17 cases. Gleason score was 3 ~ 9 points.The prostate specific antigen (PSAA) was 1.02ng / ml, 88.76ng / ml.Results all the 28 cases were successfully completed, the operation time was 125 minutes and 210 minutes, with an average of 160 minutes.The volume of blood loss during operation was 100 to 850 ml, with an average of 245 ml, and 1 case received intraoperative blood transfusion.The postoperative hospitalization time was 7 days and 26 days, with an average of 11.2 days.The mean time of indwelling urethral catheter after operation was 1528 days. Urinary leakage occurred in an average of 20.5d.3 patients. After conservative treatment, urinary incontinence was recovered in 8 cases. Urinary control ability was recovered in 7 cases after bladder training and pelvic floor muscle exercise. One case had genuine urinary incontinence.The urethral stricture was found in 2 cases without peripheral organ injury. The urethral stricture and transurethral dilatation of bladder neck were all recovered after transurethral urethral dilatation.Postoperative pathological margin was positive in 1 case.The postoperative follow-up ranged from 5 to 23 months (mean 10.8 months). No tumor recurrence or metastasis was found. The PSA was less than 0.14 ng / ml 3 months after operation.Conclusion ELRP is a feasible minimally invasive method for the treatment of localized prostate cancer. Mastering the operative skills is the key to the safety and effectiveness of the operation.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R737.25

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