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目的:探讨经腹膜外腹腔镜前列腺癌根治术的手术方法和疗效。方法:对7例局限性前列腺癌患者实施经腹膜外前列腺癌根治术。结果:7例手术均成功完成,手术时间145～250 min,平均175 min。估计术中出血量200～600 ml,平均300 ml,其中3例患者输400 ml红细胞悬液,术中无腹膜破裂、直肠输尿管损伤、膀胱损伤等病例;术后病理均报告切缘阴性,无淋巴结转移,留置导尿14～23天,平均18.2天;术后1～3天肠道功能恢复,平均1.6天。术后发生尿漏2例,6天后尿漏消失。随访3～10个月,平均6个月,术后拔除尿管出现轻度尿失禁3例(43%),1周内完全恢复尿控率71.4%(5/7),第1、3、6个月完全恢复控尿率分别为71.4%(5/7)、85.7%(6/7)、100%(7/7),术后3个月检查血清PSA<0.2μg/L,随访期间未出现生化复发。结论:腹腔镜下腹膜外途径前列腺癌根治术创伤小、并发症少、恢复快,是局限性前列腺癌安全有效的外科治疗方法。
Objective: To investigate the surgical method and effect of radical retroperitoneal laparoscopic radical prostatectomy. Methods: Seven patients with localized prostate cancer underwent radical extraperitoneal radical prostatectomy. Results: All the 7 cases were successfully completed. The operation time was 145-250 min (mean, 175 min). Estimated intraoperative blood loss of 200 ~ 600 ml, an average of 300 ml, of which 3 patients lost 400 ml of erythrocyte suspension, no peritoneal rupture, rectal ureteral injury, bladder injury and other cases; postoperative pathology were reported negative margins, no Lymph node metastasis, indwelling catheterization 14 to 23 days, an average of 18.2 days; 1 to 3 days after intestinal function recovery, an average of 1.6 days. Postoperative urinary leakage occurred in 2 cases, urinary leakage disappeared after 6 days. All cases were followed up for 3 to 10 months with an average of 6 months. Postoperative urinary incontinence was found in 3 cases (43%), complete control of urinary control rate was 71.4% (5/7) in 1 week, At 6 months, the rate of complete urine control was 71.4% (5/7), 85.7% (6/7) and 100% (7/7), respectively. Serum PSA <0.2μg / L at 3 months postoperatively No biochemical recurrence occurred. Conclusions: Laparoscopic peritoneal radical prostatectomy is a safe and effective surgical treatment for localized prostate cancer with less trauma, fewer complications and faster recovery.