3D与2D腹腔镜前列腺癌根治术治疗前列腺癌综合效果及并发症比较

doi:10.3969/j.issn.10056483.2019.02.007

摘要/Abstract

摘要： 目的：比较分析3D与2D腹腔镜前列腺癌根治术在前列腺癌治疗中的综合效果及并发症。方法：选取82例行腹腔镜前列腺癌根治术病人，根据手术方式不同分为3D组和2D组，3D组行3D腹腔镜手术治疗，2D组行2D腹腔镜手术治疗，每组各41例，回顾性研究两组病人的临床资料。对两组病人的术中出血量、术中保留性神经、手术时间、尿道重建时间、手术切缘阳性率等指标进行比较，同时对病人术后半年进行随访，对比两组病人术后尿失禁发生率、保留勃起功能成功率、生化复发率及其他并发症情况。结果：与病人比较，3D组病人手术时间（61.35±16.45）min，术中出血量（98.73±80.56）ml，尿道重建时间（23.65±11.39）min较2D组[（72.46±17.63）min，（135.67±95.74）ml，（31.52±14.68）min]明显降低，差异具有统计学意义（P<0.05）。与2D组病人（12.20%）比较，3D组病人手术切缘阳性率（7.32%）虽降低，但差异无统计学意义（P>0.05）。3D组病人术后尿失禁发生率（4.88%）明显低于2D组病人（21.95%），保留勃起功能成功率（43.90%）明显高于2D组病人（9.76%），生化复发率（0.00%）明显低于2D组病人（7.32%），差异具有统计学意义（P<0.05）。结论：3D腹腔镜技术与2D腹腔镜相比，能够更有效地控制术中出血量，缩短尿道重建时间，提升勃起功能保留成功率的同时降低了术后并发症发病率，在复杂手术中优势较为明显，值得在临床推广。

关键词: 前列腺癌根治术, 3D腹腔镜, 2D腹腔镜, 治疗效果

Abstract: Objective：To compare and analyze the combined effects and complications of 3D and 2D laparoscopic radical prostatectomy in the treatment of prostate cancer.Methods：Eightytwo patients undergoing laparoscopic radical prostatectomy from June 2015 to April 2017 were selected and divided into group I（3D laparoscopy）and group II（2D laparoscopy）according to the surgical approach.Each group had 41 cases，of which clinical data were retrospectively analyzed.The operation time，intraoperative blood loss，intraoperative nerve retention，urethral reconstruction time，surgical margin positive rate，and other surgical parameters were compared between the two groups.Patients were followed up for half a year and the postoperative urine was compared between the two groups.Incidence of incontinence，retention of erectile function success rate，postoperative biochemical recurrence rate，and other complications.Results：Compared with the 2D group，the operation time（61.35±16.45）min，the intraoperative blood loss（98.73±80.56）ml，and the urethral reconstruction time（23.65±11.39）min were significantly lower in the 3D group，the difference was statistically significant（P<0.01）.Compared with the 2D group，the positive rate of surgical margin（7.3%）was lower in the 3D group，but there was no statistically significant difference（P>0.05）.The incidence of postoperative urinary incontinence in patients in the 3D group（4.88%）was significantly lower than that in the 2D group（21.95%），the success rate of retention of erectile function（43.90%）was significantly higher than that in the 2D group（9.76%）.the biochemical recurrence rate（0.00%）significantly lower than the 2D group（7.32%），the difference was statistically significant（P<0.05）.Conclusion：Compared with 2D laparoscope，3D laparoscopy can more effectively control intraoperative blood loss，shorten urethral reconstruction time，improve the success rate of erectile function retention，and reduce the incidence of postoperative complications.More obvious，worthy of clinical promotion.

Key words: prostatectomy, 3D laparoscopy, 2D laparoscopy, therapeutic effect

庞松强, 罗功唐, 宋瑶. 3D与2D腹腔镜前列腺癌根治术治疗前列腺癌综合效果及并发症比较[J]. 临床外科杂志, 2019, 27(2): 109-112.

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