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目的:探讨腹腔镜前列腺癌根治术的手术技巧及改进方法,以减少该术式围术期并发症的发生。方法:回顾性分析54例接受腹腔镜前列腺癌根治术患者临床资料:年龄58～76岁,中位年龄68岁。前列腺特异抗原(PSA)为1.6～40.6 ng/ml,Gleason评分≤8分,术前病理检查证实为前列腺癌。均作手术治疗。结果:平均手术时间233(120～425)min,平均出血量335(100～800)ml。术后输尿管损伤1例,直肠损伤1例,尿漏6例,均自愈。术后出现不同程度尿失禁12例,6个月内恢复尿控。术后病理检查切缘阳性8例。随访42例,随访时间为1～36个月,无尿道狭窄。结论:有效控制背深静脉丛,精细解剖前列腺尖部,保护尿控神经,良好吻合尿道膀胱等,能有效地减少腹腔镜前列腺癌根治术围术期并发症的发生。
Objective: To explore the surgical technique and the improved method of laparoscopic radical prostatectomy to reduce the perioperative complications. Methods: A retrospective analysis of 54 cases of patients undergoing laparoscopic radical prostatectomy clinical data: aged 58 to 76 years, with a median age of 68 years. Prostate specific antigen (PSA) 1.6 ~ 40.6 ng / ml, Gleason score ≤ 8 points, preoperative pathology confirmed prostate cancer. Are for surgery. Results: The mean operative time was 233 (120-425) min with an average blood loss of 335 (100-800) ml. Postoperative ureteral injury in 1 case, rectal injury in 1 case, urinary leakage in 6 cases, all self-healing. Postoperative urinary incontinence in varying degrees in 12 cases, 6 months to restore urine control. Positive margins of postoperative pathological examination in 8 cases. Follow-up 42 cases, followed up for 1 to 36 months, no urethral stricture. CONCLUSION: Effective control of dorsal deep venous plexus, fine dissection of the prostatic apex, protection of the urinary control nerves, and good anastomosis of the urinary bladder can effectively reduce the incidence of perioperative complications during laparoscopic radical prostatectomy.