3D与2D腹腔镜下前列腺癌根治术的临床疗效比较研究

杨飞亚; 刘雍; 王梦童; 邢念增

doi:10.13201/j.issn.1001-1420.2017.06.011

3D与2D腹腔镜下前列腺癌根治术的临床疗效比较研究

- 1. 首都医科大学附属北京朝阳医泌尿外科(北京, 100020);
- 2. 威海市立医院泌尿外科

详细信息

通讯作者: 邢念增,E-mail:xingnianzeng@126.com

中图分类号: R737.25

收稿日期: 2016-12-20

Comparison between 3D and 2D laparoscopic radical prostatectomy in prostate cancer treatment

- 1. Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China;
- 2. Department of Urology, Weihai Municipal Hospital

More Information

Corresponding author: XING Nianzeng, E-mail: xingnianzeng@126.com

Received Date: 20 December 2016

摘要

摘要: 目的:比较3D腹腔镜与2D腹腔镜下腹膜外途径前列腺癌根治术的临床疗效。方法:回顾性分析2012年2月~2016年6月共114例行腹腔镜下前列腺癌根治术患者的临床资料,所有手术均由同一术者主刀完成,其中2D腹腔镜组53例,3D腹腔镜组61例。对比两组的手术时间、尿道重建时间、术中出血量、术后尿失禁、术中保留性神经、手术切缘阳性率、术后随访时间和术后生化复发率等指标。结果:114例前列腺癌根治术均在腹腔镜下完成,无中转开放;2D腹腔镜组手术时间为60~190min,平均128.9min;尿道吻合时间10~30min,平均23.1min;术中出血10~1 500ml,平均110.4ml;术后1个月尿失禁15例(28.3%)、术后3个月尿失禁4例(7.4%);术中保留性神经9例(17%);PT₂切缘阳性2例(阳性率8.3%);术后随访4~36个月,平均20.7个月;4例患者生化复发。其中3D腹腔镜组手术时间为40~180min,平均99.2min;尿道吻合时间10~28min,平均20.5min;术中出血10~800 ml,平均86.6 ml;术后1个月尿失禁14例(22.9%)、术后3个月尿失禁3例(4.9%);术中保留性神经11例(18%);PT₂切缘阳性2例(阳性率5.4%);术后随访4~33个月,平均20.8个月;生化复发2例。114例术后病理均证实为前列腺癌,Gleason评分5~9分。结论:与2D腹腔镜相比,3D腹腔镜下腹膜外途径前列腺癌根治术手术时间短,尿道重建更精准快捷,术中出血少,术后并发症少,安全性更高。
- 腹腔镜 /
- 3D /
- 2D /
- 前列腺癌根治术
Abstract: Objective:To compare the short-term clinical efficacy between 3D and 2D laparoscopic radical prostatectomy (LRP). Method:From February 2012 to June 2016, the data from 114 patients with prostate cancer were analyzed.The patients were randomized to two groups:the former 2D-LRP (53 cases) and the latter 3D-LRP (61 cases). We compared operative time, urethral anastomosis time, blood loss, urinary incontinence rate, nerve sparing rate, PT₂ positive surgical margin, follow-up period, biochemical recurrence rate between the two groups.Result:All of the 114 cases successfully underwent laparoscopic radical prostatectomy without conversion to open operation.As for the items of 2D vs 3D, the mean operative time were 128.9 (range, 60-190) min and 99.2 (range, 40-180) min, mean urethral anastomosis time were 23.1 (range, 10-30) min and 20.5 (range, 10-28) min, mean blood loss were 110.4 (range, 10-1 500) ml and 86.6 (range, 10-800) ml, the rate of nerve sparing were 17% and18%, PT₂ positive rate of surgical margins were 8.3% and 5.4%, urinary incontinence rate were 28.3% and 22.9% (postoperative 1month) , and 7.4%and 4.9% (postoperative 3 months) respectively.The postoperative pathology were all prostate cancer and Gleason score was from 5 to 9.All cases were followed up for approximately20.7 (range, 4-36) months and 20.8 (range, 4-33) months in 2D and 3D group respectively.There were four and two cases of biochemical recurrence in 2D and 3D group respectively.Conclusion:Compared with 2D laparoscopy, 3D LRP is safe and feasible, and makes anatomic compartments clearer, surgical separation more meticulous and suture more accurate.
- laparoscopy /
- 3D /
- 2D /
- radical prostatectomy

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