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目的探讨经腹膜外途径腹腔镜前列腺癌根治术治疗前列腺癌的可行性并观察其疗效。方法回顾分析我科2010年10月至2013年9月经腹膜外途径腹腔镜前列腺癌根治术治疗10例前列腺癌患者的临床诊治资料。结果本组10例手术均获得成功,无中转开放手术。手术时间315~495 min,平均(416±62)min,术中出血量150~1 500 ml,平均(546±135)ml,3例术后输血4~6 U,6例未输血。术后48 h内胃肠功能恢复,术后3~5 d下床活动,无直肠损伤,1例吻合口尿漏,留置切口引流管8 d后漏尿消失。标本切缘阳性3例。3例患者术后半年仍有轻度尿失禁。随访至今,未发现肿瘤局部远处转移;3例患者术后6个月~1年出现生化复发。结论经腹膜外途径腹腔镜前列腺癌根治术是治疗前列腺癌一种安全有效的手术方法,手术创伤小,出血少,并发症少,患者恢复快。
Objective To investigate the feasibility of transperitoneal laparoscopic radical prostatectomy for the treatment of prostate cancer and to observe its curative effect. Methods The clinical data of 10 patients with prostate cancer treated by laparoscopic extraperitoneal laparoscopic radical prostatectomy from October 2010 to September 2013 in our department were retrospectively analyzed. Results The group of 10 cases of surgery were successful, no transit open surgery. The operative time ranged from 315 to 495 minutes with an average of (416 ± 62) min. The blood loss was 150 to 1 500 ml (546 ± 135) ml on average. Blood transfusions occurred in 4 to 6 U in 3 patients and in 6 patients were not transfused. The gastrointestinal function recovered within 48 h after operation, and got out of bed 3 to 5 days after operation. There was no rectal injury, one case of anastomosis urinary leakage, and the incontinence incision drainage tube disappeared after 8 days. The specimens were positive in 3 cases. Three patients still had mild urinary incontinence six months after operation. Up to now, no distant metastasis of the tumor has been found. Biochemical recurrence occurred in 3 patients after 6 months to 1 year. Conclusion The extraperitoneal route of laparoscopic radical prostatectomy is a safe and effective surgical method for the treatment of prostate cancer. It has less trauma, less bleeding, fewer complications and faster recovery.