本文選題：前列腺癌 + 根治術�。� 參考：《中南大學》2014年碩士論文

【摘要】：目的通過對比開放前列腺癌根治術(Retropubic radical prostatectomy,RRP)與腹腔鏡前列腺癌根治術(Laparoscopic radical prostatectomy,LRP)兩種不同手術方式的圍手術期并發(fā)癥及臨床療效,評價腹腔鏡前列腺癌根治術治療局限性前列腺癌的手術安全性及臨床價值。 方法回顧分析中南大學湘雅二醫(yī)院泌尿外科于2009年1月至2013年10月期間行前列腺癌根治手術的患者89例,其中行RRP52例,行LRP37例,分別比較兩種術式的術前年齡、術前Gleason評分、術前臨床分期、術中出血量、手術時間、術后疼痛評分、術后通氣時間、留置導尿時間、圍手術期并發(fā)癥、術后住院天數(shù)、術后1年尿控率、切緣陽性率等各項指標。 結果兩組手術均順利完成,LRP組無病例需中途轉開放。LRP組與RRP組術中平均出血量分別為(314±201)ml與(785±526)ml,兩者間具有顯著性差異(p0.01);LRP組手術時間為(236±131)min,與RRP組平均手術時間(1924±105)min(p0.01),對于中高危需行盆腔淋巴結清掃術的患者,其手術時間分別平均另需62分鐘和47分鐘；術后疼痛評分LRP組與RRP組分別為(2.37±1.89)與(3.46±1.53)(p0.05)；平均術后通氣時間LRP與RRP分別為(65±16)h與(69±21)h(p0.05)；術后留置導尿時間分別為LRP組(13.84±2.68)d與RRP組(14.25±3.62)d(p0.05)；平均術后住院天數(shù)分別為(11.6±4.3)d與(14.5±6.2)d(p0.05)；術后1年尿控率分別為90.3%(28/31)與88.1%(37/42)(p0.05)；切緣陽性率分別為27%(10/37)與23.1%(12/52)(p0.05)。 結論腹腔鏡前列腺癌根治術比開放手術具有微創(chuàng)、出血少、恢復快等優(yōu)勢,而術后尿失禁、切緣陽性率及圍手術期并發(fā)癥的發(fā)生率與開放術相似,LRP治療局限性前列腺癌是安全可靠的。
[Abstract]:Objective to compare the perioperative complications and clinical efficacy between open radical prostatectomy and laparoscopic radical prostatectomy for prostate cancer. To evaluate the safety and clinical value of laparoscopic radical prostatectomy for localized prostate cancer. Methods A retrospective analysis was made on 89 patients undergoing radical prostatectomy in the Department of Urology, Xiangya second Hospital, Central South University, from January 2009 to October 2013, including RRP52 and LRP37. The preoperative age and preoperative Gleason score of the two operations were compared. Clinical stage, intraoperative bleeding volume, operative time, postoperative pain score, postoperative ventilation time, indwelling time, perioperative complications, postoperative hospitalization days, postoperative urinary control rate, positive rate of incision margin, and so on. Results the average intraoperative blood loss in the LRP-free group and the RRP group was 314 鹵201)ml and 785 鹵526ml, respectively. There was significant difference between the two groups. The operative time of the LRP-free group was 236 鹵131 minutes, and that of the RRP group was 1924 鹵105 minutes. Patients with middle and high risk requiring pelvic lymph node dissection, The average operation time was 62 minutes and 47 minutes respectively. The postoperative pain scores of LRP group and RRP group were 2.37 鹵1.89 and 3.46 鹵1.53, respectively; the mean postoperative ventilation time of LRP and RRP were 65 鹵16 hours and 69 鹵21 h respectively; the time of postoperative indwelling catheterization were 13.84 鹵2.68 days in LRP group and 14.25 鹵3.62 days in RRP group; the average postoperative hospitalization days were 11.6 鹵4.3 days and 14.5 鹵6.2 days (p0.05) respectively, and the duration of postoperative indwelling urinary catheterization were 13.84 鹵2.68 days in LRP group and 14.25 鹵3.62 days in RRP group respectively, and the average postoperative hospitalization days were 11.6 鹵4.3 days and 14.5 鹵6.2 days (p0.05), respectively, one year after operation, the postoperative indwelling time was 13.84 鹵2.68 days in LRP group and 14.25 鹵3.62 days in RRP group. The urinary control rates were 90.33% and 88.1T / 42, respectively, and the positive rates of the incision margin were 27 / 10 / 37) and 23.1% / 52% respectively. Conclusion Laparoscopic radical prostatectomy has the advantages of minimally invasive, less bleeding and faster recovery than open prostatectomy, while postoperative urinary incontinence. The positive rate of incision margin and the incidence of perioperative complications are similar to those of open surgery. LRP is safe and reliable in the treatment of localized prostate cancer.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.25

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本文編號：1976346