摘要
目的：总结单术者最初100例机器人辅助腹腔镜下根治性前列腺切除术（robotic-assistedlaparoscopicradicalprostatectomy，RALRP）患者的临床资料，探讨术者快速度过RALRP学习曲线的经验。方法回顾性收集我院2012年6月至2014年11月单术者最初100例RALRP患者的临床资料。年龄50～87岁，平均67岁。前列腺特异性抗原（PSA）1．3～214．0μg／L，平均值20．3μg／L。临床分期T1a～T2b期89例，T2c期4例，T3a～T4期7例。低危患者16例，中危患者37例，高危患者47例。采用移动平均法对手术时间和术中出血量进行学习曲线分析。结果100例均顺利完成，无中转开放手术者。手术时间120～480min，平均221min（包括机械臂放置时间）。术中出血量50～800ml，平均207ml，术中输血2例。切缘阳性26例（26％）。术后3个月尿控恢复（尿垫使用≤1块）80例（89％）；另10例随访不足3个月，其中5例尿控恢复。对手术时间和术中出血量的分析提示，85～90例后进入比较稳定的时期。结论RALRP学习曲线短，即便处于学习初期，患者总体治疗效果仍较好。
Objective To review the clinical data of the first 100 consecutive robotic-assisted laparoscopic radical prostatectomy （ RALRP） performed by a single surgeon , and to provide our experience in passing the learning curve of RALRP .Methods The retrospective study enrolled 100 consecutive patients diagnosed with prostate cancer from June 2012 to November 2014, who had undertaken RALRP , performed by Prof.Gao Xu.The patients aged 67 （50 to 87） years, with a mean PSA level of 20.3 （1.3 to 214.0）μg/L, among which 89 had a clinical staging of T1a to T2b, 4 staged T2c, and 7 staged T3a to T4.Of the patients, 16, 37, and 47 patients were categorized as low , intermediate, and high risk level , respectively. The operation time and blood loss volume were analyzed by moving average method .Results RALRP in all 100 cases were carried out successfully , with no conversion to open prostatectomy .The mean operation time was 221 （120 to 480） min, with an average intraoperative blood loss of 207 （50 to 800） ml; 2 cases received blood transfusion.Positive surgical margin rate was 26%.Eighty （89%） of 90 cases had recovery of continence （ equal to or less than 1 pad used daily ） 3 months postoperatively;10 cases had a follow-up time less than 3 months, and 5 had gained recovery of continence .The operation time and blood loss volume were stable at the 85th -90th case.Conclusion RALRP has a short learning curve , with a promising overall treatment outcome in the early phase of learning .
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2015年第10期774-776,共3页
Chinese Journal of Urology
