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目的探讨腹腔镜经腹腔途径前列腺癌根治术的可行性。方法采用Montsouris七步法行腹腔镜前列腺癌根治术。结果10例手术均获成功。手术时间330～540min,平均433min。术中出血量100～550ml,平均274ml,均未输血。膀胱损伤1例,当即予以缝合。术后住院时15～23d,平均17d。拔除导尿管时间14～23d,平均16d;尿漏2例分别于术后20、23d后拔除痊愈;余8例术后2周拔除。3例出现轻度尿失禁,辅助治疗4周后消失。病检pT1c3例,pT26例,pT31例。随访3～21个月,平均7.5月。术后PSA0～2.70μg/L,平均0.05μg/L。2例性功能恢复。结论严格掌握手术适应证,充分的术前准备,Montsouris七步法腹腔镜前列腺癌根治术可行。
Objective To investigate the feasibility of laparoscopic radical prostatectomy via peritoneal approach. Methods The method of Montsouris seven-step laparoscopic radical prostatectomy. Results 10 cases of surgery were successful. Operation time 330 ~ 540min, an average of 433min. Intraoperative blood loss 100 ~ 550ml, an average of 274ml, no blood transfusion. Bladder injury in 1 case, immediately be sutured. After hospitalization 15 ~ 23d, an average of 17d. Catheter removal time 14 ~ 23d, an average of 16d; 2 cases of urinary leakage were removed after 20,23 days after surgery cured; the remaining 8 cases were removed 2 weeks after surgery. 3 cases of mild urinary incontinence, adjuvant treatment disappeared after 4 weeks. Disease examination pT1c3 cases, pT26 cases, pT31 cases. Follow-up 3 to 21 months, an average of 7.5 months. Postoperative PSA0 ~ 2.70μg / L, an average of 0.05μg / L. 2 cases of functional recovery. Conclusion Strict surgical indications, adequate preoperative preparation, Montsouris seven-step laparoscopic radical prostatectomy feasible.