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摘要: 目的 探讨单孔机器人辅助单纯前列腺切除术(spRASP)治疗良性前列腺增生(BPH)的可行性及临床应用价值。方法 回顾性分析2020年11月—2021年6月上海中医药大学附属曙光医院泌尿中心7例采用spRASP治疗BPH患者的临床资料。平均年龄(67±9)岁。经估算的平均前列腺体积(78.3±12.9) mL; 平均残余尿(PVR)(58.0±24.8) mL; 平均国际前列腺症状评分(IPSS)(20.9±5.9)分，平均生活质量评分(QOL)(4.7±1.5)分，平均最大尿流率(Qmax)(7.9±3.6) mL/s。比较患者术前和术后3个月的IPSS评分、QOL评分、PVR、Qmax、IIEF等差异，分析评价手术疗效。结果 7例手术均顺利完成。平均手术时间(85.5±25.5) min，平均估计出血量(75.5±25.5) mL，平均留置引流管时间(3.4±0.8) d，平均留置尿管时间(7.5±1.2) d，术后平均住院时间(5.1±3.1) d。术后3个月患者平均IPSS评分(10.8±3.1)分、平均QOL评分(1.6±0.9)分、平均PVR(15.3±4.6) mL，与术前比较均明显降低(P < 0.05)，平均Qmax(24.4±11.6) mL/s与术前比较明显升高(P < 0.05)，IIEF与术前比较差异无统计学意义(P>0.05)。结论 spRASP是治疗BPH患者安全、有效的方法。Abstract: Objectives To assess the feasibility and efficacy of single-port robot assisted simple prostatectomy (spRASP) for the treatment of benign prostatic hyperplasia (BPH).Methods From November 2020 to June 2021, 7 patients with BPH were treated by spRASP in the urology center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. The average patients' age was (67±9) years. The estimated prostate volume was (78.3±12.9) mL; preoperative residual urine volume was (58.0±24.8) mL; the average International Prostate Symptoms Score (IPSS) was (20.9±5.9) scores, the average Quality of Life Score (QOL) was (4.7±1.5) scores, the average maximum urine flow rate (Qmax) was (7.9±3.6) mL/s, respectively. All patients agreed to accept spRASP. The pre-operative and three months post-operative IPSS, QOL, residual urine and Qmax were compared and analyzed.Results All seven patients were successfully completed. The average operation time was (85.5±25.5) min, the average estimated blood loss was (75.5±25.5) mL, drainage time was (3.4±0.8) days, catheterization time was (7.5±1.2) days, postoperative hospital stay was (5.1±3.1) days. Three months after surgery, patient' s IPSS was (10.8±3.1) scores, QOL was (1.6±0.9) scores, the average residual urine was (15.3±4.6) mL and Qmax was (24.4±11.6) mL/s, respectively. All the parameters significantly improved compared with the preoperative data (P < 0.05).Conclusion spRASP is a safe and effective treatment for patients with BPH.
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Key words:
- robotic single-port surgery /
- laparoscope /
- Madigan /
- benign prostatic hyperplasia /
- prostatectomy
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表 1 术前与术后3个月随访结果比较
X ± S 项目 术前 术后3个月 P值 PVR/mL 58.0±24.8 15.3±4.6 < 0.05 IPSS评分/分 20.9±5.9 10.8±3.1 < 0.05 QOL评分/分 4.7±1.5 1.6±0.9 < 0.05 Qmax/(mL·s-1) 7.9±3.6 24.4±11.6 < 0.05 IIEF 55.2±10.8 53.4±12.3 >0.05 
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