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经腹和腹膜外腹腔镜根治性前列腺切除术的比较研究

Comparation of the transperitoneal and extraperitoneal laparoscopic radical prostatectomy

摘要:

目的 对比经腹和腹膜外途径腹腔镜根治性前列腺切除术的差异.方法 回顾性分析2002年6月至2013年1月期间190例因前列腺癌行腹腔镜根治性前列腺切除术的患者,其中经腹腹腔镜根治性前列腺切除术患者116例,经腹膜外腹腔镜根治性前列腺切除术患者74例.比较经腹腹腔镜和腹膜外腹腔镜根治性前列腺切除临床指标(年龄、体重指数、手术时间、出血量、术后引流拔出时间,术后平均住院时间)、围手术期及术后早期并发症的差异.结果 2组患者平均年龄,身高,体重,体重指数,穿刺活检的Gleason评分及临床分期均具有可比性.与接受经腹腹腔镜根治性前列腺切除术相比,经腹膜外腹腔镜根治性前列腺切除术的手术时间短(中位数146 min,Z=-7.220,P=0.000)、术后引流时间短(中位数3d,Z=-7.115,P=0.000),术后平均住院时间短(中位数5d,Z=-7.250,P=0.000),差异有统计学意义;而2组间Gleason评分、病理分期、切缘阳性率、术中及术后早期并发症差异均无统计学意义(P>0.05).结论 与经腹腹腔镜前列腺根治性切除术相比,经腹膜外途径的手术时间更短,术后平均住院日更短,手术效果无明显差异.

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abstracts:

Objective To compare the transperitoneal laparoscopic radical prostatectomy procedures with extraperitoneal laparoscopic radical prostatectomy procedures to assess for differences in outcomes and complications.Methods A retrospective review 190 patients who had received laparoscopic radical prostatectomy for prostate cancer from June 2002 to January 2013.The results were compared between 116 transperitoneal laparoscopic radical prostatectomy procedures and 74 extraperitoneal laparoscopic radical prostatectomy procedures.Results The cohorts were similar in terms of mean patient age,height,weight,body mass index,Gleason score from biopsy,and clinical stage.Patients receiced extraperitoneal laparoscopic radical prostatectomy had shorter operation time (146 minutes vs.224 minutes,Z =-7.220,P =0.000),less postoperative drainage time (3 days vs.7 days,Z =-7.115,P =0.000) and shorter postoperative length of hospital stay (5 days vs.10 days,Z =-7.250,P =0.000) than patients receiced transperitoneal procedures.However,the Gleason score,pathological stage,positive margin rate,intraoperative and early postoperative complications has no differences between the 2 groups (P > 0.05).Conclusions The patients who received extraperitoneal laparoscopic radical prostatectomy had shorter operative time and revovered faster recovery and the effect of surgery was similar.

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