摘要
目的分析并比较筋膜内与筋膜间保留神经的腹膜外腹腔镜前列腺癌根治术(ELRP)治疗前列腺癌(PCa)的效果及复发率。方法抽取2013年1月至2016年5月南阳市中心医院收治的98例PCa患者的临床资料进行回顾性分析,根据手术方案分为筋膜内膜组(46例)和筋膜间组(52例),两组分别接受筋膜内和筋膜间保留神经的ELRP并完成术后随访,比较两组各项指标的差异。结果筋膜内组术后导尿时间和住院时间短于筋膜间组(P<0.05),两组手术时间、术中出血量和引流时间比较差异未见统计学意义(P>0.05);两组术后病理分期和切缘阳性率比较,差异未见统计学意义(P>0.05);筋膜内组术后6个月、1年、3年尿失禁和勃起功能障碍(ED)发生率低于筋膜间组(P<0.05);筋膜内组和筋膜间组术后随访时间分别为42.7、40.9个月,两组复发率分别为26.09%、32.69%(P>0.05),生存率分别为84.78%、80.77%(P>0.05);Gleason评分2~4分为高分化,4~7分为中分化,两组随访期间复发率分别为43.24%、21.31%,差异有统计学意义(P<0.05),生存率分别为72.97%、88.52%,差异有统计学意义(P<0.05)。结论筋膜内保留神经的ELRP治疗PCa的切缘阳性率与术后复发率与筋膜间手术相当,同时其可减少术后尿失禁和ED发生,对促进患者康复具有积极作用。
Objective To analyze and compare the effects and the recurrence rates of extraperitoneal laparoscopic radical prostatectomy (ELRP) with intrafascial and interfascial nerve-preservation in patients with prostate cancer (PCa).Methods Clinical data of 98 patients with PCa in Nanyang Central Hospital from January 2013 to May 2016 were retrospectively analyzed. According to the different surgical procedures, the patients were divided into intrafascial group (46 cases)and interfascial group(52 cases). The patients were given intrafascial and interfascial ELRP respectively, and postoperative follow-up was completed, and the differences of various indexes were compared between the two groups.Results The postoperative catheterization time and hospital stay in intrafascial group were significantly lower than those in interfascial group (P<0.05), and there were no significant differences in the operative time, intraoperative blood loss and drainage time between the two groups (P>0.05). There were no significant differences in the postoperative pathological stage and positive rate of incisal margin between the two groups (P>0.05). The incidence rates of urinary incontinence and erectile dysfunction (ED) at 6 months, 1 year and 3 years after operation in intrafascial group were significantly lower than those in interfascial group (P<0.05). The postoperative follow-up time was 42.7 months in intrafascial group and 40.9 months in interfascialgroup respectively, and the recurrence rates were 26.09% and 32.69% (P>0.05), and the survival rates were 84.78% and 80.77% respectively (P>0.05). The Gleason score of 2-4 points was set as high differentiation, and score of 4-7 points was set as moderate differentiation, the recurrence rates of the two groups were 43.24% and 21.31% respectively during the follow-up period, the difference was statistically significant (P<0.05), and the survival rate was 72.97% and 88.52% respectively, the difference was statistically significant (P<0.05).Conclusions Intrafascial nerve-preservation ELRP for
作者
李征
杨立新
刘磊
Li Zheng;Yang Lixin;Liu Lei(Department of Urology Surgery,Nanyang Central Hospital,Nanyang 473000,China)
出处
《中国实用医刊》
2020年第4期64-68,共5页
Chinese Journal of Practical Medicine
关键词
腹腔镜前列腺癌根治术
前列腺癌
筋膜内
筋膜间
保留神经
Extraperitoneal laparoscopic radical prostatectomy
Prostate cancer
Intrafascial
Interfascial
Nerve-preservation
